Saini, Urvi, Rosmalen, Judith G M, Oldehinkel, Albertine J et al. · Journal of psychosomatic research · 2024 · DOI
This study looked at how symptoms of depression, anxiety, ME/CFS, fibromyalgia, and irritable bowel syndrome are connected in over 70,000 people. Researchers found that these conditions tend to cluster separately, but are linked together through specific 'bridge' symptoms like fatigue, difficulty concentrating, and sleep problems. This helps explain why people often experience multiple conditions at the same time.
This research provides evidence that ME/CFS symptoms—particularly fatigue and cognitive difficulties—are key connectors between psychiatric and functional somatic conditions, suggesting shared biological mechanisms. Understanding these symptom bridges may help clinicians recognize and treat underlying causes rather than treating conditions in isolation, potentially improving outcomes for ME/CFS patients with comorbid mood or anxiety disorders.
This study cannot establish causation or determine whether bridge symptoms cause comorbidity or merely reflect it. The cross-sectional design means we cannot determine the temporal sequence of symptom development. The findings also do not explain the biological mechanisms underlying these symptom connections.
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
Saini, Urvi, Rosmalen, Judith G M, Oldehinkel, Albertine J, & van Loo, Hanna M (2024). Connecting the dots: Network structures of internalizing and functional symptoms in a population-based cohort.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2024.111932
BibTeX
@article{mecfsatlas-saini-2024-connecting-dots,
author = {Saini, Urvi and Rosmalen, Judith G M and Oldehinkel, Albertine J and van Loo, Hanna M},
title = {Connecting the dots: Network structures of internalizing and functional symptoms in a population-based cohort.},
journal = {Journal of psychosomatic research},
year = {2024},
doi = {10.1016/j.jpsychores.2024.111932},
note = {PubMed: 39298869},
url = {https://www.mecfsatlas.com/evidence/saini-2024-connecting-dots},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/saini-2024-connecting-dots
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