Schweitzer, R, Robertson, D L, Kelly, B et al. · Journal of psychosomatic research · 1994 · DOI
This study asked 40 patients with ME/CFS to complete questionnaires about their health concerns and mood. Compared to people visiting general doctors, ME/CFS patients reported more worry about their health and stronger belief that they had a serious illness. However, they were less likely to think their symptoms were purely psychological. About two-thirds of the ME/CFS patients also showed signs of depression or anxiety on screening tests.
Understanding illness behaviour patterns in ME/CFS is important because it helps distinguish between health-focused concern that reflects genuine disease burden versus psychological distress. These findings suggest ME/CFS patients have legitimate reasons for health vigilance based on their condition, while also highlighting the significant mood and anxiety symptoms that often accompany this illness.
This study does not establish whether heightened health concerns in ME/CFS patients are adaptive responses to real physiological dysfunction or maladaptive illness beliefs. The cross-sectional design cannot determine causation—it cannot show whether illness behaviour patterns contribute to CFS symptoms or result from them. The study also does not assess whether these psychological measures reflect accurate perception of disease severity.
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
Schweitzer, R, Robertson, D L, Kelly, B, & Whiting, J (1994). Illness behaviour of patients with chronic fatigue syndrome.. Journal of psychosomatic research. https://doi.org/10.1016/0022-3999(94)90007-8
BibTeX
@article{mecfsatlas-schweitzer-1994-illness-behaviour,
author = {Schweitzer, R and Robertson, D L and Kelly, B and Whiting, J},
title = {Illness behaviour of patients with chronic fatigue syndrome.},
journal = {Journal of psychosomatic research},
year = {1994},
doi = {10.1016/0022-3999(94)90007-8},
note = {PubMed: 8126689},
url = {https://www.mecfsatlas.com/evidence/schweitzer-1994-illness-behaviour},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/schweitzer-1994-illness-behaviour
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