White, P D, Pinching, A J, Rakib, A et al. · Journal of the Royal Society of Medicine · 2002 · DOI
This study compared ME/CFS patients attending two different hospital clinics—one run by immunology doctors and one by psychiatry doctors—to see if they were similar. Researchers found that patients at both clinics had very similar symptoms, disability levels, and emotional distress, even though they chose different clinics. The main difference was that immunology clinic patients were more likely to believe their fatigue was caused by physical problems, while psychiatry clinic patients were more open to other explanations.
This study helps clarify that ME/CFS is not fundamentally different depending on which type of clinic a patient attends, potentially reducing fragmentation in research and clinical care. It highlights that patients with similar disease burden may seek care differently based on their beliefs about causation, suggesting that both physical and psychological support approaches are needed regardless of etiology. Understanding these patterns can help healthcare systems better serve ME/CFS patients by recognizing they may benefit from integrated rather than siloed care.
This study does not prove what causes ME/CFS or whether physical or psychological factors are primary; it only shows that patients' illness beliefs influence which clinic they choose. The cross-sectional design cannot establish causal relationships or whether clinic attendance affects outcomes over time. It also does not validate the medical model of either clinic—similar clinical presentation does not confirm a shared underlying etiology.
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
White, P D, Pinching, A J, Rakib, A, Castle, M, Hedge, B, & Priebe, S (2002). A comparison of patients with chronic fatigue syndrome attending separate fatigue clinics based in immunology and psychiatry.. Journal of the Royal Society of Medicine. https://doi.org/10.1177/014107680209500904
BibTeX
@article{mecfsatlas-white-2002-comparison-patients,
author = {White, P D and Pinching, A J and Rakib, A and Castle, M and Hedge, B and Priebe, S},
title = {A comparison of patients with chronic fatigue syndrome attending separate fatigue clinics based in immunology and psychiatry.},
journal = {Journal of the Royal Society of Medicine},
year = {2002},
doi = {10.1177/014107680209500904},
note = {PubMed: 12205207},
url = {https://www.mecfsatlas.com/evidence/white-2002-comparison-patients},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/white-2002-comparison-patients
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