Cognitive behaviour therapy in chronic fatigue syndrome

A randomised controlled trial with 12-month follow-up was undertaken at the infectious diseases department outpatient clinic in Oxford, UK. 60 consecutive patients with chronic fatigue syndrome were included in the study. Various exclusion criteria were used including if the patient was receiving psychotherapy or antidepressant drugs that reduced symptoms.

Half of the patients were allocated to medical care alone and half were allocated to cognitive behaviour therapy plus medical care. The latter group of patients exhibited improved function in comparison to the group receiving medical treatment alone (1)

NICE state that with respect to symptomatic management in ME (myalgic encephalitis)/chronic fatigue syndrome (CFS)

Cognitive behavioural therapy (CBT)

• CBT should only be offered to support people who live with ME/CFS to manage their symptoms, improve their functioning and reduce the distress associated with having a chronic illness
• the NICE committee
  • "..wanted to highlight that cognitive behavioural therapy (CBT) has sometimes been assumed to be a cure for ME/CFS. However, it should only be offered to support people who live with ME/CFS to manage their symptoms, improve their functioning and reduce the distress associated with having a chronic illness..."
  • "..The committee agreed if a child or young person would like to use CBT, it was important to adapt the therapy taking into account their cognitive and emotional maturity..."
  • ".. The qualitative evidence showed that people with ME/CFS have found CBT useful when delivered by a therapist who understands ME/CFS, but also that there is the potential for harm when it is inappropriately delivered. To avoid this, the committee made the recommendation about who should deliver CBT and the clinical supervision they should have..."

Reference:

• .Sharpe M et al (1996). Cognitive behaviour therapy for chronic fatigue syndrome: a randomised controlled trial. BMJ, 312, 22-6.
• NICE (October 2021). Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management