Roy-Byrne, P, Smith, W R, Goldberg, J et al. · Psychological medicine · 2004 · DOI
This study examined whether trauma and PTSD are more common in people with fibromyalgia and chronic fatigue syndrome. Researchers found that among 571 patients, about 20% had experienced PTSD and 42% had depression. The link between fibromyalgia symptoms (pain and tender points) and PTSD was strongest in patients who also had depression, suggesting that depression may play an important role in how trauma and chronic pain conditions are connected.
This study is important because it identifies a potential subgroup of ME/CFS and fibromyalgia patients—those with comorbid depression—who may benefit from trauma-informed care. Understanding the relationship between trauma, depression, and chronic pain/fatigue conditions could improve diagnostic approaches and treatment planning, particularly regarding the role of psychiatric assessment in these complex conditions.
This study does not prove that trauma causes fibromyalgia or ME/CFS, only that these conditions co-occur at elevated rates in certain subgroups. The cross-sectional design means we cannot determine the direction of causality—trauma could precede illness, illness could increase PTSD risk, or depression could be the common underlying factor. The findings also do not apply to CFS criteria, which showed no significant association with PTSD.
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
Roy-Byrne, P, Smith, W R, Goldberg, J, Afari, N, & Buchwald, D (2004). Post-traumatic stress disorder among patients with chronic pain and chronic fatigue.. Psychological medicine. https://doi.org/10.1017/s0033291703008894
BibTeX
@article{mecfsatlas-roy-byrne-2004-post-traumatic,
author = {Roy-Byrne, P and Smith, W R and Goldberg, J and Afari, N and Buchwald, D},
title = {Post-traumatic stress disorder among patients with chronic pain and chronic fatigue.},
journal = {Psychological medicine},
year = {2004},
doi = {10.1017/s0033291703008894},
note = {PubMed: 14982142},
url = {https://www.mecfsatlas.com/evidence/roy-byrne-2004-post-traumatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/roy-byrne-2004-post-traumatic
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