Thompson, D, Hylan, T R, McMullen, W et al. · The American journal of psychiatry · 1998 · DOI
This study looked at insurance records from nearly 1,700 people who started taking antidepressants for depression in the early 1990s. The researchers wanted to understand whether treating depression could also reduce overall healthcare costs. They found that patients with certain conditions—including chronic fatigue syndrome, anxiety, heart disease, and cancer—who stayed on antidepressants for at least 6 months tended to have lower medical bills overall.
This study is notable because it includes chronic fatigue syndrome (ME/CFS) as a comorbid condition associated with potential cost reduction when depression is treated. For ME/CFS patients who also experience depression, understanding whether antidepressant treatment may reduce overall healthcare utilization could inform clinical decision-making and help patients and providers evaluate treatment options.
This study does not prove that antidepressants treat ME/CFS itself or that they improve ME/CFS symptoms. It only shows a statistical association between antidepressant use and reduced healthcare costs in a claims database—correlation does not establish causation. The reasons for cost reduction (improved depression, reduced care-seeking, spontaneous improvement, or other factors) remain unclear.
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
Thompson, D, Hylan, T R, McMullen, W, Romeis, M E, Buesching, D, & Oster, G (1998). Predictors of a medical-offset effect among patients receiving antidepressant therapy.. The American journal of psychiatry. https://doi.org/10.1176/ajp.155.6.824
BibTeX
@article{mecfsatlas-thompson-1998-predictors-medical,
author = {Thompson, D and Hylan, T R and McMullen, W and Romeis, M E and Buesching, D and Oster, G},
title = {Predictors of a medical-offset effect among patients receiving antidepressant therapy.},
journal = {The American journal of psychiatry},
year = {1998},
doi = {10.1176/ajp.155.6.824},
note = {PubMed: 9619157},
url = {https://www.mecfsatlas.com/evidence/thompson-1998-predictors-medical},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/thompson-1998-predictors-medical
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