Clinical Rheumatology

, Volume 25, Issue 2, pp 183–188

Depression, attribution style and self-esteem in chronic fatigue syndrome and fibromyalgia patients: is there a link?

  • H. J. Michielsen
  • B. Van Houdenhove
  • I. Leirs
  • P. Onghena
  • A. Vandenbroeck
Original Article

DOI: 10.1007/s10067-005-1154-1

Cite this article as:
Michielsen, H.J., Van Houdenhove, B., Leirs, I. et al. Clin Rheumatol (2006) 25: 183. doi:10.1007/s10067-005-1154-1


The aims of the present study were to compare a single diagnosis (chronic fatigue syndrome, CFS) and a double diagnosis (CFS + fibromyalgia, CFS + FM) group regarding depression, attribution style and self-esteem as well as to examine whether attribution style is a mediator in the relationship between self-esteem and depression. Eighty-five patients (CFS: 47, CFS + FM: 38) completed questionnaires on attribution style, self-esteem and depression. The single and double diagnosis groups tended to differ slightly, but the differences were never statistically significant. In addition, only one condition was met of the four conditions mentioned by Baron and Kenny to establish that mediation exists between two variables. In conclusion, an external attribution style does not protect the CFS or CFS + FM patients with a low self-esteem from depression. The prevalence rate of depression was high in both patient samples, of which clinicians should be aware.


Attribution styleChronic fatigue syndromeDepressionFibromyalgiaMediatorSelf-esteem



Chronic fatigue syndrome




Hospital Anxiety and Depression Scale


Multidimensional Health Locus of Control Scale

Copyright information

© Clinical Rheumatology 2006

Authors and Affiliations

  • H. J. Michielsen
    • 1
  • B. Van Houdenhove
    • 2
  • I. Leirs
    • 3
  • P. Onghena
    • 3
  • A. Vandenbroeck
    • 4
  1. 1.Department of Psychology and HealthTilburg UniversityTilburgThe Netherlands
  2. 2.Department of Liaison PsychiatryUniversity Hospital Gasthuisberg, UZ GasthuisbergLeuvenBelgium
  3. 3.Faculty of Psychology and Educational SciencesK.U. LeuvenLeuvenBelgium
  4. 4.University Hospital GasthuisbergK.U. LeuvenLeuvenBelgium