Functional status, neuropsychological functioning, and mood in chronic fatigue syndrome (CFS): relationship to psychiatric disorder.
Tiersky, Lana A, Matheis, Robert J, Deluca, John et al.·The Journal of nervous and mental disease·2003
This study looked at how depression and anxiety affect people with ME/CFS. Researchers compared four groups: people with ME/CFS alone, people with ME/CFS plus mental health symptoms that started after CFS, people with ME/CFS plus mental health symptoms that started before CFS, and healthy controls. The main finding was that while mental health problems don't make the physical fatigue and weakness worse, they do make people feel more emotionally distressed—especially if those mental health issues came before the CFS diagnosis.