Thomas, Nathaniel Stembridge, Neale, Michael C, Kendler, Kenneth S et al. · Psychological medicine · 2025 · DOI
This study followed over 100,000 people over time to understand how depression, anxiety, fibromyalgia, and ME/CFS relate to each other. The researchers found that these conditions tend to be connected, but the direction of the connection varies: fibromyalgia appears to lead to depression, while ME/CFS and depression seem to influence each other in both directions. The study suggests that these conditions should be studied separately rather than grouped together, since they may work differently.
Understanding whether ME/CFS causes depression or vice versa—or whether they influence each other mutually—is crucial for developing targeted treatments. This study provides evidence that ME/CFS may have a bidirectional relationship with mood disorders, suggesting that treating one condition may help the other, and that patients experiencing both deserve integrated care approaches.
This study demonstrates associations over time but cannot definitively prove causation; the bidirectional relationships could be explained by shared underlying biological mechanisms or unmeasured factors. The results are 'consistent with' a causal link from fibromyalgia to depression but do not conclusively establish it. Additionally, findings from a Dutch population-based cohort may not generalize to all ME/CFS populations, particularly those with more severe disease.
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 Stembridge, Neale, Michael C, Kendler, Kenneth S, van Loo, Hanna M, & Gillespie, Nathan A (2025). Prospective associations between major depressive disorder, generalized anxiety disorder, fibromyalgia, and myalgic encephalomyelitis/chronic fatigue syndrome.. Psychological medicine. https://doi.org/10.1017/S0033291725100603
BibTeX
@article{mecfsatlas-thomas-2025-prospective-associations,
author = {Thomas, Nathaniel Stembridge and Neale, Michael C and Kendler, Kenneth S and van Loo, Hanna M and Gillespie, Nathan A},
title = {Prospective associations between major depressive disorder, generalized anxiety disorder, fibromyalgia, and myalgic encephalomyelitis/chronic fatigue syndrome.},
journal = {Psychological medicine},
year = {2025},
doi = {10.1017/S0033291725100603},
note = {PubMed: 40785390},
url = {https://www.mecfsatlas.com/evidence/thomas-2025-prospective-associations},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/thomas-2025-prospective-associations
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