Evidence browser

Perceived misdiagnosis of psychiatric conditions in autistic adults.

Kentrou, Vasiliki, Livingston, Lucy A, Grove, Rachel et al.·EClinicalMedicine·2024

This study found that many autistic adults, especially women, were given different psychiatric diagnoses (like depression, anxiety, or personality disorders) before being correctly diagnosed with autism. About 1 in 4 autistic adults and 1 in 3 autistic women reported receiving at least one psychiatric diagnosis that they felt was wrong. This delayed their access to proper autism support and treatment.

An online survey among convalescents 5 months post SARS-CoV-2 infection in China.

Wang, Yalan, Liu, Maoshun, Guo, Yuanyuan et al.·Biosafety and health·2024

This study surveyed over 5,500 people in China about five months after they had COVID-19 to see what long-term health problems they experienced. The most common complaints were fatigue (tiredness), memory problems, post-exertional malaise (feeling much worse after physical activity), and brain fog. People with certain pre-existing conditions like heart disease, autoimmune diseases, or asthma were more likely to have moderate to severe symptoms.

E2 ModerateCohortPEM not requiredObservational

Clinical Characteristics of Persistent Hypophosphatasemia Uncovered in Adult Patients: A Retrospective Study at a Japanese Tertiary Hospital.

Fujiwara, Shintaro, Otsuka, Yuki, Furukawa, Masanori et al.·Journal of clinical medicine·2024

This study looked at blood test results from over 50,000 patients to find out how common persistently low alkaline phosphatase (an enzyme in the blood) is and what causes it. Researchers found that about 0.5% of patients had persistently low levels, and identified cancer, steroid use, and immunosuppressant medications as the main causes. Importantly, 14% of patients with low alkaline phosphatase had no clear explanation, and some of these patients had symptoms like chronic pain, muscle weakness, and fatigue that could indicate a rare bone disease called hypophosphatasia.

E2 ModerateCohortPEM unclearCase-Control

Hypothalamus Connectivity in Adolescent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Byrne, Hollie, Knight, Sarah J, Josev, Elisha K et al.·Journal of neuroscience research·2024

Researchers used brain imaging (MRI) to look at a small brain region called the hypothalamus in teenagers with ME/CFS compared to healthy teenagers. They found some differences in how the hypothalamus connects to other parts of the brain in people with ME/CFS, and these differences appeared related to how long someone had been sick and how severe their fatigue was. This is one of the first studies to examine this specific brain region in adolescents with ME/CFS.

E2 ModerateBehavioralPEM not requiredCross-Sectional

The association between Long-COVID symptomology, perceived symptom burden and mental health in COVID-19 patients in Shijiazhuang, China: a population-based health survey.

Li, Yufei, Lam, Lawrence T, Xiao, Ying et al.·Frontiers in psychiatry·2024

This study looked at 25% of COVID-19 patients in China who had symptoms lasting longer than two months after infection. Researchers found that patients with more Long-COVID symptoms—especially fatigue and post-exertional malaise (feeling worse after activity)—were more likely to experience depression and anxiety. The more severe patients felt their symptoms were, the greater their mental health struggles.

E2 ModerateCohortPEM requiredObservational

An Adaptive Pacing Intervention for Adults Living With Long COVID: A Narrative Study of Patient Experiences of Using the PaceMe app.

Meach, Rachel, Carless, David, Sanal-Hayes, Nilihan E M et al.·Journal of patient experience·2024

This study looked at how a smartphone app called PaceMe helps people with long COVID manage their symptoms by balancing activity with rest. Twenty-five people used the app and were interviewed about their experience after 3-6 months. The app helped participants better understand and manage post-exertional malaise (the worsening of symptoms after activity), feel supported, and feel more in control of their condition.

Gut MicrobiomeImmune System

Systemic antibody responses against gut microbiota flagellins implicate shared and divergent immune reactivity in Crohn's disease and chronic fatigue syndrome.

Bourgonje, Arno R, Hörstke, Nicolai V, Fehringer, Michaela et al.·Microbiome·2024

This study looked at immune responses in ME/CFS and Crohn's disease patients by measuring antibodies against proteins from gut bacteria called flagellins. Researchers found that both patient groups had elevated antibodies against these bacterial proteins, but the pattern of where these antibodies attached differed between the two diseases. These antibody patterns could potentially help doctors diagnose ME/CFS and understand how the immune system may be responding abnormally to gut bacteria.

E2 ModerateCohortPEM unclearLongitudinal

Muscle abnormalities worsen after post-exertional malaise in long COVID.

Appelman, Brent, Charlton, Braeden T, Goulding, Richie P et al.·Nature communications·2024

This study looked at muscle tissue changes in long COVID patients, particularly focusing on post-exertional malaise (PEM)—the worsening of fatigue and pain after activity. Researchers found that muscles in long COVID patients showed structural damage, metabolic problems, and unusual deposits that got worse after activity triggered PEM. These findings help explain why exertion makes symptoms worse in some long COVID patients.

Energy MetabolismPost-Exertional Malaise

Long COVID diagnostic with differentiation from chronic lyme disease using machine learning and cytokine hubs.

Patterson, Bruce K, Guevara-Coto, Jose, Mora, Javier et al.·Scientific reports·2024

Researchers developed a computer-based test using blood measurements called cytokines to accurately identify long COVID (also called PASC) in patients. The test was able to correctly identify long COVID in 97% of cases and correctly rule it out in 90% of cases when tested on a new group of people. Importantly, the test could also distinguish long COVID from chronic Lyme disease, which can cause similar symptoms, helping doctors diagnose the right condition.

Immune System

E2 ModerateCohortPEM requiredCross-Sectional

Service users' and parents/carers' experiences of a paediatric chronic fatigue service: A service evaluation.

Hartley, Gemma, Purrington, Jack·Chronic illness·2024

This study asked children with chronic fatigue syndrome (ME/CFS) and their parents about their experiences at a specialist clinic that treats young people with the condition. Most families felt the service helped them understand their illness better, learn useful strategies to manage their symptoms, and gradually increase their activity levels safely. However, some families had trouble accessing the service due to its location, appointment scheduling, and difficulty contacting staff.

Heterogeneity in Measures of Illness among Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Is Not Explained by Clinical Practice: A Study in Seven U.S. Specialty Clinics.

Unger, Elizabeth R, Lin, Jin-Mann S, Chen, Yang et al.·Journal of clinical medicine·2024

Researchers studied 465 ME/CFS patients across seven specialized clinics in the United States to see if doctors diagnosed and recognized the same disease. They found that while the clinics had similar patients, there was tremendous variation in how sick individual patients were—some had mild symptoms while others were severely affected. This suggests that ME/CFS may naturally come in many different forms, and understanding these differences could help improve research and treatment.

E2 ModerateCohortPEM not requiredCase-Control

Increased risk of chronic fatigue syndrome following pneumonia: A population-based Cohort study.

Hsu, Han-Jen, Chang, Hsun, Lin, Cheng-Li et al.·Journal of infection and public health·2024

This study found that people who have pneumonia are about 1.4 times more likely to develop ME/CFS compared to people who don't have pneumonia. The risk was higher for certain types of bacterial and viral infections, including specific bacteria like Pseudomonas and Streptococcus pneumoniae, as well as influenza virus. The researchers used health records from 2 million adults in Taiwan to track whether pneumonia patients developed ME/CFS over time.

E2 ModerateCohortPEM unclearCase-Control

Case-control study on post-COVID-19 conditions reveals severe acute infection and chronic pulmonary disease as potential risk factors.

Ghosh, Pritha, Niesen, Michiel J M, Pawlowski, Colin et al.·iScience·2024

This study looked at nearly 89,000 COVID-19 patients to understand why some develop long COVID (lasting symptoms months after infection) while others recover quickly. Researchers found that people with a history of lung disease, migraines, or fibromyalgia were more likely to develop long COVID, and those who had severe acute COVID infections were also at higher risk. The findings suggest that reducing the severity of the initial COVID infection, especially in vulnerable patients, might help prevent long COVID from developing.

Energy Metabolism

E2 ModerateBehavioralPEM not requiredCross-Sectional

[The Significance of Chronic Fatigue in the Post-Covid Consultation and its Consequences for Outpatient Rehabilitation in the Context of Statutory Accident Insurance].

Dalichau, Stefan, Kordy, Henrike, Klüver, Janna et al.·Psychotherapie, Psychosomatik, medizinische Psychologie·2024

This study looked at 454 people (mostly women aged 40–60) who developed long-term fatigue after COVID-19. Nearly all of them reported severe tiredness, and over 73% also experienced brain fog. The fatigue lasted about 14–15 months on average and significantly affected their ability to work and enjoy daily life. The researchers recommend that treatment should focus on managing chronic fatigue similar to ME/CFS, using education and practical coping strategies rather than trying to 'cure' the condition.

Cognitive Impairment

Comparison of the symptom networks of long-COVID and chronic fatigue syndrome: From modularity to connectionism.

Hyland, Michael E, Antonacci, Yuri, Bacon, Alison M·Scandinavian journal of psychology·2024

This study compared how symptoms are connected to each other in long-COVID and ME/CFS patients, along with people who have other conditions like fibromyalgia and IBS. Researchers found that while long-COVID and ME/CFS are related conditions, their symptoms connect differently—ME/CFS symptoms form more separate clusters, whereas long-COVID symptoms are more tightly linked together. The study suggests that these conditions may work through a network-like system in the body rather than a single broken mechanism.

Assessing health state utilities for people with myalgic encephalomyelitis/chronic fatigue syndrome in Australia using the EQ-5D-5L, AQoL-8D and EQ-5D-5L-psychosocial instruments.

Orji, Nneka C, Cox, Ingrid A, Jason, Leonard A et al.·Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation·2024

This study measured how much ME/CFS affects quality of life in 198 Australian people with the condition. Researchers used three different questionnaires to assess health-related quality of life and found that people with ME/CFS reported significantly lower quality of life scores compared to healthy people. As people's fatigue and disability became more severe, their quality of life scores dropped further.

Energy MetabolismImmune System

Untargeted Metabolomics and Quantitative Analysis of Tryptophan Metabolites in Myalgic Encephalomyelitis Patients and Healthy Volunteers: A Comparative Study Using High-Resolution Mass Spectrometry.

Abujrais, Sandy, Vallianatou, Theodosia, Bergquist, Jonas·ACS chemical neuroscience·2024

Researchers compared blood chemistry between 38 people with ME/CFS and 24 healthy people to understand what might be different in their bodies. They found several chemical imbalances, particularly in how the body processes tryptophan (an amino acid) and in pathways related to energy production and inflammation. These differences suggest that ME/CFS patients may experience unusual immune activity and stress damage to their cells.

E2 ModerateCohortPEM not requiredObservational

In major dysmood disorder, physiosomatic, chronic fatigue and fibromyalgia symptoms are driven by immune activation and increased immune-associated neurotoxicity.

Maes, Michael, Almulla, Abbas F, Zhou, Bo et al.·Scientific reports·2024

This study found that people with severe depression often experience fatigue and pain symptoms similar to ME/CFS, and these symptoms are linked to overactive immune responses in the body. Researchers measured immune molecules in the blood of severely depressed patients and healthy controls, and discovered that specific immune markers—particularly IL-16 and IL-8—were associated with how severe the fatigue and physical symptoms were. The study suggests that difficult life experiences and traumatic childhood events may trigger these immune changes, leading to the physical symptoms that patients experience.

Immune System

Risk of chronic fatigue syndrome after COVID-19: A retrospective cohort study of 3227281 patients.

Chen, Chih-Wei, Lee, Hsun-Hua, Chang, Shu-Hao et al.·Journal of infection and public health·2024

This study looked at over 6 million patient records to compare people who had COVID-19 with people who didn't. Researchers found that people who had COVID-19 were about 1.6 times more likely to develop chronic fatigue syndrome (CFS) afterward. The increased risk appeared in people of all ages, both sexes, and different racial backgrounds.

Long COVID Overlap