Wiedbusch, Elzbieta, Cotler, Joseph, Jason, Leonard A · Journal of preventive medicine & healthcare · 2021
This study compared how ME/CFS affects people in the United States and Japan by surveying 124 Japanese patients and 210 U.S. patients. The research found that U.S. patients reported more severe brain fog, stomach problems, and exhaustion after activity compared to Japanese patients. Interestingly, Japanese women experienced similar levels of disability as American patients despite being less likely to receive official disability support.
Most ME/CFS research focuses on U.S. and UK populations, leaving gaps in understanding how this disease manifests across different healthcare systems and cultures. This study provides rare international data showing that disease severity and disability access vary geographically, which could inform more culturally sensitive clinical care and policy recommendations globally.
This study does not establish that cultural or genetic differences cause the observed symptom variations—only that they exist. The study is observational and cross-sectional, so it cannot determine whether differences in symptom reporting reflect true biological differences, disparities in diagnosis, healthcare access, or cultural factors in symptom interpretation. Tertiary-care recruitment may not represent all ME/CFS patients.
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
Wiedbusch, Elzbieta, Cotler, Joseph, & Jason, Leonard A (2021). A Comparison of Patients with Chronic Fatigue Syndrome and Myalgic Encephalomyelitis from the United States and Japan.. Journal of preventive medicine & healthcare. https://pubmed.ncbi.nlm.nih.gov/36507470/
BibTeX
@article{mecfsatlas-wiedbusch-2021-comparison-patients,
author = {Wiedbusch, Elzbieta and Cotler, Joseph and Jason, Leonard A},
title = {A Comparison of Patients with Chronic Fatigue Syndrome and Myalgic Encephalomyelitis from the United States and Japan.},
journal = {Journal of preventive medicine & healthcare},
year = {2021},
note = {PubMed: 36507470},
url = {https://www.mecfsatlas.com/evidence/wiedbusch-2021-comparison-patients},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/wiedbusch-2021-comparison-patients
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