Generative AI acceptance and professional autonomy development among Chinese university physical education teachers: a moderated conditional process model.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a distinct chronic neurologic disorder, is characterized by over 6 months of fatigue that is unimproved by rest (). ME/CFS has an average prevalence of 1.4%, with women being nearly 1.5- to 2-fold more frequently affected than men (). ME/CFS presents with many symptoms, such as impaired memory, unrefreshing sleep, headache, and muscle pain (). There is a significant overlap between ME/CFS and other chronic diseases (). Due to the elusive etiology, diagnostic difficulty, and impaired quality of life associated with ME/CFS, identifying factors associated with current ME/CFS status is of great implication for clinical characterization and public health surveillance. ME/CFS is frequently preceded by diverse infections, such as Epstein–Barr virus, human herpes virus 6, and COVID-19 (). Autoimmune and inflammatory disorders also share some key pathogenic features with ME/CFS. For example, inflammatory bowel disease, herpes zoster, and psoriasis were associated with an increased risk of ME/CFS (). Multiple biological pathways are involved in the development and progression of ME/CFS. Of note, adults with ME/CFS often experience multimorbidity burden, such as depression, which is one of the most common and costly illnesses in US, with a rising prevalence over the past three decades (). Fatigue is one of the highly prevalent symptoms of depression (). Meanwhile, depression is a well-recognized determinant of fatigue (). The impact of depression on fatigue far exceeded other factors in patients with hemodialysis (). Hence, an in-depth investigation of the role of depression in ME/CFS is of important clinical significance. Accumulating evidence indicates that adults with depression and anxiety present an increased risk of ME/CFS, particularly among those taking antidepressants (). Depression was a risk factor for fatigue in epilepsy patients (). It was also observed that depression rates were significantly higher in ME/CFS adolescents than that in the general populations (). ME/CFS with co-morbid psychopathology tend to be biased in thinking and fatigue symptoms (). Current ME/CFS was operationally defined using NHIS questions on prior clinician-diagnosed ME/CFS and whether participants still had ME/CFS at the time of interview. Depression may be associated with current ME/CFS status by modulating fatigue severity and chronicity. However, the role of disease history in the association between depression history and current ME/CFS remains unclear. Hence, an in-depth investigation based on the impact of chronic disease history on the association between depression history and current ME/CFS is helpful for understanding the clinical profile of adults reporting current ME/CFS.