E2 ModeratePreliminaryPEM not requiredCross-SectionalPeer-reviewedReviewed
Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder in People with Long COVID, ME/CFS, and Controls.
Sanal-Hayes, Nilihan E M, Hayes, Lawrence D, Mclaughlin, Marie et al. · The American journal of medicine · 2025 · DOI
Quick Summary
This study compared how often people with long COVID, ME/CFS, and healthy people experience trauma-related mental health conditions. Researchers found that people with long COVID had the highest rates of these conditions (38% combined), followed by people with ME/CFS (20%), while healthy people had none. Both long COVID and ME/CFS groups showed more trauma-related symptoms than controls across multiple measures.
Why It Matters
This is the first direct comparison of trauma-related mental health conditions between long COVID and ME/CFS, highlighting that both conditions may be associated with significant psychological distress beyond physical symptoms. Understanding these associations could improve holistic care approaches for both populations.
Observed Findings
- Long COVID group had 38% combined PTSD/CPTSD prevalence compared to 20% in ME/CFS and 0% in controls
- Long COVID participants showed significantly elevated scores across all PTSD symptom clusters compared to controls
- Both long COVID and ME/CFS groups demonstrated greater Disturbances in Self-Organization (DSO) scores than controls
- No PTSD cases (only CPTSD) were found in the ME/CFS group, contrasting with long COVID's 5% PTSD prevalence
- Overall symptom scores differed significantly between both patient groups and healthy controls
Inferred Conclusions
- Individuals with long COVID experience higher prevalence of PTSD and CPTSD than those with ME/CFS and healthy controls
- Both long COVID and ME/CFS are associated with elevated trauma-related psychological symptoms compared to the general population
- Complex PTSD (involving both re-experiencing and self-organization disturbances) appears more prevalent than isolated PTSD in these chronic illness populations
Remaining Questions
- Do trauma-related symptoms develop as a consequence of living with these illnesses, or do they reflect pre-existing vulnerabilities in affected individuals?
- What specific aspects of long COVID and ME/CFS experiences might trigger or maintain trauma-related symptoms?
What This Study Does Not Prove
This study cannot establish whether trauma-related symptoms are caused by the illness experience itself, pre-existing vulnerabilities, or other factors. The small sample sizes and lack of clinical confirmation of diagnoses limit generalizability. Correlation between these conditions and trauma symptoms does not prove causation.
Tags
Phenotype:Long COVID Overlap
Method Flag:Weak Case DefinitionSmall SampleExploratory Only
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 →
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