Terman, M, Levine, S M, Terman, J S et al. · The American journal of medicine · 1998 · DOI
This study looked at whether ME/CFS symptoms get worse during winter months, similar to seasonal depression. Researchers asked 110 ME/CFS patients about their symptoms in summer and winter, and found that about one-third showed a seasonal pattern with winter worsening. This suggests that some ME/CFS patients might benefit from light therapy, a treatment commonly used for seasonal depression.
This research identifies a clinically meaningful subgroup of ME/CFS patients with seasonal symptom patterns who may respond to light therapy, offering a non-pharmacological treatment option. Understanding seasonal variation within ME/CFS heterogeneity is important for personalizing treatment approaches and may explain why some patients experience winter deterioration while others do not.
This study does not prove that seasonal affective disorder causes ME/CFS or vice versa, nor does it establish that light therapy is effective—only that it may warrant investigation. The cross-sectional design with retrospective ratings cannot determine causality or whether seasonality reflects true physiological variation or reporting bias. The study does not definitively establish separate disease subtypes, only that symptom clusters differ between groups.
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
Terman, M, Levine, S M, Terman, J S, & Doherty, S (1998). Chronic fatigue syndrome and seasonal affective disorder: comorbidity, diagnostic overlap, and implications for treatment.. The American journal of medicine. https://doi.org/10.1016/s0002-9343(98)00172-7
BibTeX
@article{mecfsatlas-terman-1998-chronic-fatigue,
author = {Terman, M and Levine, S M and Terman, J S and Doherty, S},
title = {Chronic fatigue syndrome and seasonal affective disorder: comorbidity, diagnostic overlap, and implications for treatment.},
journal = {The American journal of medicine},
year = {1998},
doi = {10.1016/s0002-9343(98)00172-7},
note = {PubMed: 9790493},
url = {https://www.mecfsatlas.com/evidence/terman-1998-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/terman-1998-chronic-fatigue
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