Ware, N C, Kleinman, A · Psychosomatic medicine · 1992 · DOI
This study examines how culture and social life shape the experience of ME/CFS and related illnesses. The researchers found that symptoms don't just come from the body—they are also influenced by what happens in patients' relationships, work, and daily lives. When patients' life circumstances improve, their symptoms often improve too, showing that body and society are deeply connected.
This research validates what many ME/CFS patients experience—that their illness is not purely biological or purely psychological, but deeply embedded in their social circumstances and relationships. Understanding this mind-body-society connection can help clinicians and patients move beyond oversimplified explanations and recognize how improving life circumstances and social support may complement medical treatment.
This review does not establish the specific biological mechanisms underlying ME/CFS, nor does it prove that social factors cause the disease. It also does not demonstrate that psychosocial interventions alone can cure ME/CFS or that the illness is primarily psychological rather than biological. The findings describe correlation and association rather than establishing definitive causation.
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
Ware, N C & Kleinman, A (1992). Culture and somatic experience: the social course of illness in neurasthenia and chronic fatigue syndrome.. Psychosomatic medicine. https://doi.org/10.1097/00006842-199209000-00003
BibTeX
@article{mecfsatlas-ware-1992-culture-somatic,
author = {Ware, N C and Kleinman, A},
title = {Culture and somatic experience: the social course of illness in neurasthenia and chronic fatigue syndrome.},
journal = {Psychosomatic medicine},
year = {1992},
doi = {10.1097/00006842-199209000-00003},
note = {PubMed: 1438658},
url = {https://www.mecfsatlas.com/evidence/ware-1992-culture-somatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/ware-1992-culture-somatic
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