Prevalence and treatment of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and co-morbid severe health anxiety
Open accessAbstract
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is a debilitating condition that affects 0.2–0.4% of the population. Health focussed anxiety is common across medical conditions, and may be relevant in CFS/ME. This study sought to identify the prevalence and impact of health anxiety (HA) in CFS/ME and evaluate the effectiveness of Cognitive Behavioural Therapy for HA in CFS/ME. Cross-sectional questionnaire methods and case-series design were used to achieve study aims. Analysis indicated that 41.9% of the CFS/ME clinic sample experienced threshold levels of health anxiety, which was associated with elevated symptom severity across several dimensions. Stepwise multiple regression indicated physical functioning and depression accounted for 23.8% of variance in fatigue; depression, fatigue and HA, accounted for 32.9% of variance in physical functioning. Large effect sizes and clinically significant changes were generated in the treatment study. HA is common in CFS/ME and likely to exacerbate fatigue and physical functioning. This study identifies HA as an important target for treatment, trial findings should be further replicated on a larger scale. El Síndrome de Fatiga Crónica/Encefalomielitis Miálgica (SFC/EM) es una enfermedad que afecta al 0,2-0.4% de la población. La ansiedad por la salud (AS) es común en condiciones médicas y puede ser relevante en el SFC/EM. El objetivo de este estudio fue identificar la prevalencia e impacto de la AS en el SFC/EM y evaluar la efectividad de la terapia cognitivo conductual para tratar la AS en el SFC/EM. Se utilizaron cuestionarios en base a un diseño transversal y de estudio de casos. El 41.9% de la muestra clínica de SFC/EM experimentó niveles umbrales de HA, lo que se asoció a una mayor gravedad de algunos síntomas. Modelos de regresión lineal múltiple indicaron que el funcionamiento físico y la depresión representaron el 23.8% de la varianza en la fatiga; la depresión, la fatiga y la AS representaron el 32.9% de la varianza en el funcionamiento físico. Se identificaron grandes tamaños de efecto y cambios clínicamente significativos por el tratamiento. Lla AS es común en el SFC/EM y podría empeorar la fatiga y el funcionamiento físico. Este estudio identifica la HA como factor importante para el tratamiento del SFC/ME. Los resultados deberían replicarse a mayor escala.
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Preliminary findings indicate that about 42% of those experiencing prolonged CF report health anxiety, linked to elevated symptom severity and poorer physical functioning.
“Preliminary findings indicate that about 42% of those experiencing prolonged CF report health anxiety, linked to elevated symptom severity and poorer physical functioning [51].”
From Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue: Nine-Month Follow-Up of a Web-Based Randomized Controlled Trial. (2026) · cites this paper as [51]
The Abstract reports that 41.9% of a CFS/ME clinic sample had threshold-level health anxiety, associated with greater symptom severity; the Study 2 Discussion also reports lower physical functioning among participants with high health anxiety. The claim broadens this clinic finding to people experiencing prolonged chronic fatigue generally, whom the study did not assess as a group. (LLM, conf=0.86)
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“Each item is scored from 0 to 3 with higher scores indicating higher levels of health anxiety and a score of ≥18 indicating severe health anxiety, consistent with previous studies (Daniels et al., 2020).”
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“Yet, pragmatic evidence from case studies suggests that treatment using a CBT-based health anxiety model can benefit those with ME/CFS who are health anxious, both in terms of their physical and mental health (Daniels and Loades, 2017; Daniels et al., 2020).”
BackgroundMethodResultInfluentialSelf-citationFatigue has a prominent impact on health lasting 12-weeks after COVID-19 infection
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“…and 7% of the general population (Cooper et al ., 2017) and 20% of those surveyed across medical settings (Tyrer et al ., 2011), with higher rates in medical conditions such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) (Daniels et al ., 2020) and chronic pain (Rode et al ., 2006).”
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- Authors
- Daniels, J., Parker, H., & Salkovskis, P. M.
- Affiliations
- North Bristol NHS Trust (GB)
- University of Bath (GB)
- Oxford Health NHS Foundation Trust (GB)
- Corresponding author
- Daniels, Jo
- Venue
- International Journal of Clinical and Health Psychology
- Publisher
- Elsevier BV
- Published
- 2020-01
- Volume
- 20
- Issue
- 1
- Pages
- 10-19
- ISSN
- 1697-2600 (ISSN-L)
- PMC
- PMC6994737
- OpenAlex
- W2998012193
- Cited by
- 26
- References
- 40
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 4
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Clinical and Health Psychology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Pure (University of Bath) (submittedVersion, cc-by-nc-nd)
- Funders
- North Bristol NHS Trust
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- chronic fatigue syndrome, health anxiety, cognitive behavioral therapy, prevalence, fatigue, physical function, depression, symptom severity, comorbidities, treatment effectiveness, quality of life, social support
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