Tiersky, Lana A, Matheis, Robert J, Deluca, John et al. · The Journal of nervous and mental disease · 2003 · DOI
This study looked at how depression and anxiety affect people with ME/CFS. Researchers compared four groups: people with ME/CFS alone, people with ME/CFS plus mental health symptoms that started after CFS, people with ME/CFS plus mental health symptoms that started before CFS, and healthy controls. The main finding was that while mental health problems don't make the physical fatigue and weakness worse, they do make people feel more emotionally distressed—especially if those mental health issues came before the CFS diagnosis.
Understanding the relationship between psychiatric symptoms and ME/CFS disability is crucial for treatment planning and prognosis. This study clarifies that psychiatric illness does not directly cause or worsen the core physical impairment of ME/CFS, but does significantly impact emotional quality of life—suggesting that mental health treatment may improve well-being without necessarily addressing underlying physical dysfunction.
This study does not prove that psychiatric illness causes ME/CFS or vice versa; it only describes associations in a snapshot at one time. The cross-sectional design cannot establish whether pre-existing psychiatric conditions make people more vulnerable to developing CFS, nor can it determine the direction of causality for psychiatric symptoms that develop after CFS onset. Results may not generalize to all CFS populations, particularly those with different severity profiles.
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
Tiersky, Lana A, Matheis, Robert J, Deluca, John, Lange, Gudrun, & Natelson, Benjamin H (2003). Functional status, neuropsychological functioning, and mood in chronic fatigue syndrome (CFS): relationship to psychiatric disorder.. The Journal of nervous and mental disease. https://doi.org/10.1097/01.NMD.0000066155.65473.26
BibTeX
@article{mecfsatlas-tiersky-2003-functional-status,
author = {Tiersky, Lana A and Matheis, Robert J and Deluca, John and Lange, Gudrun and Natelson, Benjamin H},
title = {Functional status, neuropsychological functioning, and mood in chronic fatigue syndrome (CFS): relationship to psychiatric disorder.},
journal = {The Journal of nervous and mental disease},
year = {2003},
doi = {10.1097/01.NMD.0000066155.65473.26},
note = {PubMed: 12819552},
url = {https://www.mecfsatlas.com/evidence/tiersky-2003-functional-status},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/tiersky-2003-functional-status
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