Thomas, Nathaniel S, Gillespie, Nathan A, Neale, Michael C et al. · Journal of psychiatric research · 2025 · DOI
This study looked at whether depression and conditions like ME/CFS, fibromyalgia, and IBS occur together more often than chance, and if so, why. Researchers analyzed data from over 10,000 people with depression and found that not all depression symptoms are equally linked to these conditions. They identified five different patterns of depression symptoms, with two patterns being most strongly associated with ME/CFS and related conditions.
This research suggests that ME/CFS comorbidity with depression is not random or caused by depression itself, but rather associated with specific symptom profiles that may reflect underlying biological mechanisms. Understanding these patterns could help clinicians better recognize which ME/CFS patients are at higher risk for depression and guide more targeted interventions.
This study does not prove that depression causes ME/CFS or vice versa—it only shows they occur together more frequently in certain depression subtypes. The cross-sectional design (measuring both conditions at different time points) cannot establish causality or temporal relationships. It also does not identify the actual biological mechanisms underlying these associations.
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, Neale, Michael C, Rosmalen, Judith G M, van Loo, Hanna M, & Kendler, Kenneth S (2025). Clinical heterogeneity in major depressive disorder underlies comorbidity with functional disorders.. Journal of psychiatric research. https://doi.org/10.1016/j.jpsychires.2025.01.056
BibTeX
@article{mecfsatlas-thomas-2025-clinical-heterogeneity,
author = {Thomas, Nathaniel S and Gillespie, Nathan A and Neale, Michael C and Rosmalen, Judith G M and van Loo, Hanna M and Kendler, Kenneth S},
title = {Clinical heterogeneity in major depressive disorder underlies comorbidity with functional disorders.},
journal = {Journal of psychiatric research},
year = {2025},
doi = {10.1016/j.jpsychires.2025.01.056},
note = {PubMed: 39923353},
url = {https://www.mecfsatlas.com/evidence/thomas-2025-clinical-heterogeneity},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/thomas-2025-clinical-heterogeneity
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