**5. Conclusions**

This comparative survey of ME/CFS patients in Italy, Latvia, and the UK has demonstrated marked similarities between respondents in all three countries in terms of demographic features, the impact of the illness on household incomes and on quality of life, and on difficulties experienced by respondents in discussing their illness with doctors. There were differences in terms of patterns of medical care, the availability of social care, and societal attitudes to ME/CFS. There is a need for internationally shared protocols for the disease treatment and diagnosis. More empirical research is required in Europe on ME/CFS patients' needs in order to develop adequate care pathways.

**Supplementary Materials:** The following are available online at https://www.mdpi.com/article/10 .3390/medicina57030300/s1.

**Author Contributions:** Conceptualization. E.B., D.A.; methodology, E.B., D.A., D.F.H.P.; validation, E.B., D.A., D.F.H.P.; formal analysis, E.B., D.A., D.F.H.P.; investigation, E.B., D.A., D.F.H.P.; resources, E.B., D.A., D.F.H.P.; writing—original draft preparation, D.F.H.P.; writing—review and editing, E.B., D.A., D.F.H.P.; visualization, E.B., D.A., D.F.H.P.; project administration, E.B., D.A. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding. EUROMENE receives funding for networking activities from the COST programme (COST Action 15111), via the COST Association.

**Institutional Review Board Statement:** This study, 'In-depth study of Chronic Fatigue Syndrome (ME/CFS) and encouraging of a common approach in international scientific cooperation' was approved by the Research Ethics Committee of the Riga Stradins University (Decision No.6-3/3, 25 October 2018, Riga).

**Informed Consent Statement:** In the UK, prospective participants respondents read a detailed statement, with response indicating informed consent. In Latvia, prospective respondents read a detailed statement, which was accepted by the Research Ethics Committee of the Riga Stradins University (Decision No.6-3/3, 25 October 2018, Riga), and response therefore indicates informed consent. In Italy respondents read a detailed statement and agreed to participate.

**Data Availability Statement:** Initial tabulations of data from the UK are available upon request from the author. Data from Italy are available on request from the author. The aggregated data of Latvia surveys are available on request from the Riga Stradins University.

**Acknowledgments:** This article is based upon work from COST Action CA15111—European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE), supported by COST (European Cooperation in Science and Technology); www.cost.eu (accessed on 15 January 2021).

**Conflicts of Interest:** The authors declare no conflict of interest.
