Smith, Lucie, Crawley, Esther, Riley, Madeleine et al. · Clinical child psychology and psychiatry · 2021 · DOI
This study looked at whether teenagers with ME/CFS lose the ability to enjoy activities they once loved. Researchers surveyed 164 young people and found that 42% experienced some loss of enjoyment, with 15% experiencing significant loss. Many of these teenagers said their condition either stopped them from doing activities or made it hard to enjoy them, even when they did participate.
This is the first study specifically examining anhedonia in adolescents with ME/CFS, filling an important knowledge gap about how the condition affects motivation and pleasure. Understanding anhedonia is crucial because it may interfere with behavioural treatments like graded activity programmes, which rely on patients' ability to engage in and find satisfaction in activities. Identifying anhedonia helps clinicians tailor more effective, individualised treatment approaches.
This study does not establish whether anhedonia is caused by ME/CFS itself, by depression that develops alongside it, or by both conditions. It cannot determine causality or directionality—it only documents that anhedonia occurs in this population. The cross-sectional design means we cannot track whether anhedonia develops before, after, or simultaneously with other CFS/ME symptoms.
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
Smith, Lucie, Crawley, Esther, Riley, Madeleine, McManus, Megan, & Loades, Maria Elizabeth (2021). Exploring anhedonia in adolescents with Chronic Fatigue Syndrome (CFS): A mixed-methods study.. Clinical child psychology and psychiatry. https://doi.org/10.1177/13591045211005515
BibTeX
@article{mecfsatlas-smith-2021-exploring-anhedonia,
author = {Smith, Lucie and Crawley, Esther and Riley, Madeleine and McManus, Megan and Loades, Maria Elizabeth},
title = {Exploring anhedonia in adolescents with Chronic Fatigue Syndrome (CFS): A mixed-methods study.},
journal = {Clinical child psychology and psychiatry},
year = {2021},
doi = {10.1177/13591045211005515},
note = {PubMed: 33863235},
url = {https://www.mecfsatlas.com/evidence/smith-2021-exploring-anhedonia},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/smith-2021-exploring-anhedonia
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