Van Den Eede, F, Moorkens, G, Hulstijn, W et al. · Psychological medicine · 2008 · DOI
This study tested how well the stress-response system (HPA axis) works in ME/CFS patients compared to healthy people. Researchers gave patients a special test involving two hormones and measured cortisol levels in saliva. They found that ME/CFS patients had lower cortisol responses than healthy controls, suggesting their stress-response system may not be working properly—but this was especially true for patients without a history of childhood trauma.
Understanding HPA axis dysfunction in ME/CFS could explain fatigue, immune dysregulation, and stress intolerance. This study adds objective biological evidence of abnormal stress hormone regulation and shows that early-life trauma history must be considered when interpreting HPA axis findings—important for both patient stratification and mechanistic research.
This study does not prove that low cortisol causes ME/CFS or that correcting it will cure the disease; it shows an association. The findings are limited to female patients and cannot be generalized to men. It also does not establish whether the HPA axis abnormality is primary or secondary to other disease mechanisms.
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
Van Den Eede, F, Moorkens, G, Hulstijn, W, Van Houdenhove, B, Cosyns, P, Sabbe, B G C, et al. (2008). Combined dexamethasone/corticotropin-releasing factor test in chronic fatigue syndrome.. Psychological medicine. https://doi.org/10.1017/S0033291707001444
BibTeX
@article{mecfsatlas-van-den-eede-2008-combined-dexamethasone,
author = {Van Den Eede, F and Moorkens, G and Hulstijn, W and Van Houdenhove, B and Cosyns, P and Sabbe, B G C and Claes, S J},
title = {Combined dexamethasone/corticotropin-releasing factor test in chronic fatigue syndrome.},
journal = {Psychological medicine},
year = {2008},
doi = {10.1017/S0033291707001444},
note = {PubMed: 17803834},
url = {https://www.mecfsatlas.com/evidence/van-den-eede-2008-combined-dexamethasone},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/van-den-eede-2008-combined-dexamethasone
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