Roberts, A D L, Charler, M-L, Papadopoulos, A et al. · Psychological medicine · 2010 · DOI
This study looked at whether a hormone called cortisol, which helps regulate stress and energy, affects how well cognitive behavioural therapy (CBT) works for ME/CFS patients. The researchers measured cortisol levels in 84 ME/CFS patients and tracked how many improved after receiving CBT. They found that patients with lower cortisol levels were less likely to respond well to CBT, suggesting that abnormal cortisol may be one reason why ME/CFS persists in some people.
This study identifies cortisol abnormalities as a potential biomarker for predicting which ME/CFS patients may not benefit from CBT, enabling more personalized treatment planning. Understanding how biological factors like hypocortisolism interact with therapeutic response could improve treatment outcomes and reduce unnecessary treatment delays for non-responders.
This study does not prove that low cortisol causes poor CBT response or poor CFS outcomes—only that they are associated. It does not establish whether normalizing cortisol would improve CBT response, nor does it explain the mechanisms linking cortisol abnormalities to treatment resistance. The observational design cannot determine causality.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Roberts, A D L, Charler, M-L, Papadopoulos, A, Wessely, S, Chalder, T, & Cleare, A J (2010). Does hypocortisolism predict a poor response to cognitive behavioural therapy in chronic fatigue syndrome?. Psychological medicine. https://doi.org/10.1017/S0033291709990390
BibTeX
@article{mecfsatlas-roberts-2010-does-hypocortisolism,
author = {Roberts, A D L and Charler, M-L and Papadopoulos, A and Wessely, S and Chalder, T and Cleare, A J},
title = {Does hypocortisolism predict a poor response to cognitive behavioural therapy in chronic fatigue syndrome?},
journal = {Psychological medicine},
year = {2010},
doi = {10.1017/S0033291709990390},
note = {PubMed: 19607750},
url = {https://www.mecfsatlas.com/evidence/roberts-2010-does-hypocortisolism},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/roberts-2010-does-hypocortisolism
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