Valero, Sergi, Sáez-Francàs, Naia, Calvo, Natalia et al. · Comprehensive psychiatry · 2013 · DOI
This study examined whether personality traits and depression influence how severe ME/CFS symptoms are in patients. Researchers looked at 229 ME/CFS patients and tested whether neuroticism (a tendency toward negative emotions) and perfectionism affect fatigue severity, and whether depression acts as a connecting link between these traits and fatigue. They found that neuroticism appears to influence fatigue severity primarily through depression—meaning people with high neuroticism tend to develop depression, which then worsens fatigue.
Understanding the psychological pathways that amplify ME/CFS fatigue could help clinicians identify which patients may benefit from psychological interventions targeting mood and emotional regulation. This research provides a more nuanced framework for how personality factors influence disease severity, potentially informing personalized treatment approaches beyond traditional medical management alone.
This study does not prove that neuroticism or depression causes ME/CFS—only that these psychological factors are associated with fatigue severity in people who already have the disease. The cross-sectional design prevents determining whether neuroticism leads to depression and worsened fatigue, or whether severe fatigue develops these psychological features. The study also does not establish whether addressing these psychological factors would actually reduce ME/CFS symptoms.
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
Valero, Sergi, Sáez-Francàs, Naia, Calvo, Natalia, Alegre, José, & Casas, Miquel (2013). The role of neuroticism, perfectionism and depression in chronic fatigue syndrome. A structural equation modeling approach.. Comprehensive psychiatry. https://doi.org/10.1016/j.comppsych.2013.04.015
BibTeX
@article{mecfsatlas-valero-2013-role-neuroticism,
author = {Valero, Sergi and Sáez-Francàs, Naia and Calvo, Natalia and Alegre, José and Casas, Miquel},
title = {The role of neuroticism, perfectionism and depression in chronic fatigue syndrome. A structural equation modeling approach.},
journal = {Comprehensive psychiatry},
year = {2013},
doi = {10.1016/j.comppsych.2013.04.015},
note = {PubMed: 23759150},
url = {https://www.mecfsatlas.com/evidence/valero-2013-role-neuroticism},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/valero-2013-role-neuroticism
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