Zdunek, Maria, Jason, Leonard A, Evans, Meredyth et al. · International journal of psychology and behavioral sciences · 2015 · DOI
This study compared ME/CFS symptoms and disability between patients in the United States and the United Kingdom to see if the illness looks different depending on where people live. Researchers found that UK patients reported more mental health problems, pain, memory/concentration issues, and immune symptoms, while US patients more often experienced sudden illness onset and attributed their illness to physical causes. The study suggests that ME/CFS may present somewhat differently across these two countries.
Understanding whether ME/CFS presents differently across populations is crucial for developing comparable diagnostic criteria internationally, interpreting research findings across countries, and ensuring treatment recommendations are appropriate for diverse patient populations. This study provides evidence that cultural, healthcare, and potentially biological factors may influence how ME/CFS manifests, which has implications for clinical recognition and research generalizability.
This study does not prove that ME/CFS is caused by different mechanisms in the US versus UK, nor does it establish why these differences exist. The cross-sectional design cannot determine causation, and differences may reflect variations in healthcare systems, diagnostic practices, or health reporting styles rather than true biological differences in the illness itself.
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
Zdunek, Maria, Jason, Leonard A, Evans, Meredyth, Jantke, Rachel, & Newton, Julia L (2015). A Cross Cultural Comparison of Disability and Symptomatology Associated with CFS.. International journal of psychology and behavioral sciences. https://doi.org/10.5923/j.ijpbs.20150502.07
BibTeX
@article{mecfsatlas-zdunek-2015-cross-cultural,
author = {Zdunek, Maria and Jason, Leonard A and Evans, Meredyth and Jantke, Rachel and Newton, Julia L},
title = {A Cross Cultural Comparison of Disability and Symptomatology Associated with CFS.},
journal = {International journal of psychology and behavioral sciences},
year = {2015},
doi = {10.5923/j.ijpbs.20150502.07},
note = {PubMed: 26478826},
url = {https://www.mecfsatlas.com/evidence/zdunek-2015-cross-cultural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/zdunek-2015-cross-cultural
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