Strickland, P, Morriss, R, Wearden, A et al. · Journal of affective disorders · 1998 · DOI
This study measured cortisol (a stress hormone) in saliva from women with ME/CFS, women with depression, and healthy women to see if cortisol levels differed between groups. Researchers found that women with ME/CFS had lower cortisol levels, especially in the evening and morning, compared to both depressed and healthy women. This suggests that ME/CFS involves different biological changes than depression.
This study provides biochemical evidence that ME/CFS involves abnormal cortisol regulation, supporting the hypothesis that ME/CFS is a distinct biological condition rather than a manifestation of depression. Understanding cortisol dysfunction in ME/CFS may help researchers identify disease mechanisms and develop targeted treatments.
This study does not establish whether low cortisol causes ME/CFS symptoms or is a consequence of the disease. It also does not explain the underlying mechanisms driving cortisol hyposecretion, nor does it determine whether findings generalize to men or to ME/CFS patients with comorbid depression.
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
Strickland, P, Morriss, R, Wearden, A, & Deakin, B (1998). A comparison of salivary cortisol in chronic fatigue syndrome, community depression and healthy controls.. Journal of affective disorders. https://doi.org/10.1016/s0165-0327(97)00134-1
BibTeX
@article{mecfsatlas-strickland-1998-comparison-salivary,
author = {Strickland, P and Morriss, R and Wearden, A and Deakin, B},
title = {A comparison of salivary cortisol in chronic fatigue syndrome, community depression and healthy controls.},
journal = {Journal of affective disorders},
year = {1998},
doi = {10.1016/s0165-0327(97)00134-1},
note = {PubMed: 9476760},
url = {https://www.mecfsatlas.com/evidence/strickland-1998-comparison-salivary},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/strickland-1998-comparison-salivary
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