Thomas, Nathaniel S, Gillespie, Nathan A, Kendler, Kenneth S et al. · General hospital psychiatry · 2024 · DOI
This study looked at how often ME/CFS, fibromyalgia, and irritable bowel syndrome occur together with depression and anxiety in over 107,000 people. The researchers found that people with one of these conditions are much more likely to also have depression or anxiety than would be expected by chance. Interestingly, these connections were even stronger in men than in women.
Understanding the high rates of comorbidity between ME/CFS and mood/anxiety disorders is crucial for improving clinical recognition and treatment strategies. This finding suggests that patients with ME/CFS should be routinely screened for depression and anxiety, and vice versa, which may lead to more comprehensive and effective care. The sex-based differences highlighted here also point toward potentially different biological or psychosocial mechanisms in men and women, informing future mechanistic research.
This study cannot establish whether depression and anxiety cause ME/CFS, result from it, or share a common underlying cause—only that they frequently co-occur. The cross-sectional design means we cannot determine the temporal sequence of symptom onset. Additionally, the results are based on self-reported diagnoses using criteria rather than clinical evaluation, which may affect accuracy and generalizability beyond the Dutch population studied.
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
Thomas, Nathaniel S, Gillespie, Nathan A, Kendler, Kenneth S, Oldehinkel, Albertine J, Rosmalen, Judith G M, & van Loo, Hanna M (2024). Comorbidity and sex differences in functional disorders and internalizing disorders.. General hospital psychiatry. https://doi.org/10.1016/j.genhosppsych.2024.07.013
BibTeX
@article{mecfsatlas-thomas-2024-comorbidity-sex,
author = {Thomas, Nathaniel S and Gillespie, Nathan A and Kendler, Kenneth S and Oldehinkel, Albertine J and Rosmalen, Judith G M and van Loo, Hanna M},
title = {Comorbidity and sex differences in functional disorders and internalizing disorders.},
journal = {General hospital psychiatry},
year = {2024},
doi = {10.1016/j.genhosppsych.2024.07.013},
note = {PubMed: 39079424},
url = {https://www.mecfsatlas.com/evidence/thomas-2024-comorbidity-sex},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/thomas-2024-comorbidity-sex
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