9) Link to the paper:
Tatten et al. 2026. Who receives a diagnostic label for fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome? A study in the lifelines cohort.
9) Link to the paper:
Tatten et al. 2026. Who receives a diagnostic label for fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome? A study in the lifelines cohort.
8 ) A bit curious that depression and anxiety were associated with lower instead of higher odds of FSS diagnosis. The authors speculate that this may reflect diagnostic overshadowing: somatic symptoms of FSS might have been attributed to a psychiatric diagnosis.
7) Older age, smoking, and reporting a depressive or an anxiety disorder were associated with lower odds of receiving an FSS diagnostic label.
6) Female sex, having lower education levels, various comorbidities, higher healthcare use, and current employment were positively associated with getting a FSS diagnosis.
(see the odds ratios from multiple logistic regression analysis in table below)
5) The rest of the paper looks at factors that differ between patients that received a diagnosis versus those that didn't. They not only looked at ME/CFS but at "Functional Somatic Syndrome (FSS)" which also includes fibromyalgia and irritable bowel syndrome.
4) The prevalence of ME/CFS in this cohort was 1.8% (2,793 out of 152,807 participants), which seems substantially higher than sound epidemiological estimates (which are usually below 1%).
3) So rather than a large number of people with CFS being undiagnosed, it could also be that this CFS Symptom Inventory selects a high number of false positives who don't actually have CFS.
2) A big caveat, however, is that cases were selected using a questionnaire (the CDC's CFS Symptom Inventory) not a clinical examination. Most diagnostic criteria for ME/CFS require a clinical examination to assess symptoms and exclude alternative causes.
1) A new paper from the Lifelines cohort reports that only 14% of people with ME/CFS received a formal diagnosis.
7) Link to the paper:
Tuzzolino. et al. 2026. Identifying post-exertional malaise subtypes: Differentiating physical and mental PEM manifestations
journals.sagepub.com...
6) To digg deeper into PEM manifestations, I think we need better questions than those from the DePaul symptom questionnaire - these focus too much on fatigue after exertion and fatiguability, not on becoming sicker much later after the (over)exertion.
5) The paper claims that "these results indicate distinct PEM subtypes" but I think it looks like the opposite: the difference between groups were not that clear and most (almost 80%) of patients fell in the group with both physical and mental PEM.
4) There was also data on how well patients managed to stay inside their energy envelope using a ratio of estimated expended and available energy * 100. Those under 94 were considered under-exerted, those above 119 over-exerted.
3) Turns out the vast majority (78%) of ME/CFS patients had both mental and physical PEM.
Only 5% fell in the mental PEM only subgroup. This tended to have more males. Otherwise the differences between groups do not look that big.
2) A score of 2 out 4 for both severity and frequency was needed for the following:
- "Mentally tired after the slightest effort", was used for mental PEM.
- “Minimum exercise makes you physically tired", was used for physical PEM.
1) A large study of ca. 2000 ME/CFS patients analyzed post-exertional malaise (PEM) scores and differences between ME/CFS subgroups that mostly experience physical or mental PEM.
This is from Lenny Jason's group in Chicago.
10) Link to the paper:
Wirth et al. 2026. ICD-10 Diagnoses prior to ME/CFS diagnosis in children and young people suggest potential early diagnostic indicators.
9) "Need for vaccination against unspecified infectious disease" had a negative association with ME/CFS while the need for vaccination against influenza or COVID-19 was positively associated with ME/CFS.
Obesity on the other hand, had a negative association (OR: 0.84).
8 ) Some results are interesting though: ADHD had a negative association (OR: 0.80) while attention deficit disorder (without hyperactivity) had a positive association (OR: 1.5) - perhaps because of the cognitive dysfunction.
7) I suspect that for most of these diagnoses the patient might have already had the illness ME/CFS (even if they didn't get a ME/CFS diagnosis G93.3 yet). So the diagnoses given before might be misdiagnoses or comorbidities, rather than risk factors.
6) A lot of other common conditions also had a weak relationship to ME/CFS, things like back pain, hypothyroidism, scoliosis, dyspnea, but also mental and behavioral disorders such as depression (OR:1.21) and somatoform disorders (OR: 1.32).
5) The biggest odds ratios were for diagnoses that overlap with ME/CFS such as fatigue (OR: 2.19), mild cognitive impairment (2.93), fibromyalgia (2.08), neurasthenia (1.67), etc.
No surprises here.
4) The analysis only looked at ME/CFS diagnoses in the years 2020-2022 and checked which ICD diagnoses were more common in patients in the year before they received their ME/CFS diagnosis.
3) Diagnoses were based on the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) where ME/CFS has the code G93.3. The researchers found ca. 6000 ME/CFS cases which were paired to ca. 5 controls matched for age, sex and location.
2) Data came from Techniker Krankenkasse, a major insurance fund covering about 15% of the German population. They looked at children and young adults aged 6-27 and found a ME/CFS incidence in this age group of 0.11%.
1) 🇩🇪 This study looked at medical diagnoses in an insurance database that preceded an ME/CFS diagnosis in children and young adults.
For example: bronchitis and sinusitis were positively associated with ME/CFS rates while vaccination or ADHD has a negative association.
To be determined later I think
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6) The steering committee and working groups will meet regularly in the future to develop a long-term strategy for the National Decade Against Post-Infectious Diseases. Further measures are to be launched before the end of this year.
5) Thirdly, working groups will be created to provide support for the steering committee on several topics. The first three will focus on:
- research infrastructure and biospecimens
- health-care related research
- translational research, bringing research into practice
