Lasting Benefits for Chronic Fatigue Syndrome Therapy

Chronic fatigue syndrome may improve with cognitive behavioral therapy, graded exercise therapy

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) Could a form of counseling be the most effective way to treat the debilitating symptoms of chronic fatigue syndrome (CFS)?

A new study from the UK found that two therapies may have long-term benefits for patients with CFS. Out of four potential treatments studied, cognitive behavioral therapy (CBT) and graded exercise therapy (GET) were found to achieve better outcomes than both adaptive pacing therapy (APT) and specialist medical care (SMC) after one year.

"The finding that participants who had cognitive behavioral therapy and graded exercise therapy had maintained their improvement over two years after entering the trial, tells us that these treatment[s] can improve the long-term health of people with CFS," said lead co-author Michael Sharpe MD, a professor of psychological medicine at the University of Oxford, in a press release.

CFS is a complex disorder marked by profound fatigue that cannot be improved by bed rest and may be worsened by physical or mental activity. Symptoms can include weakness, muscle pain, impaired mental concentration and insomnia.

CBT is a form of mental health counseling, or psychotherapy, that helps patients become aware of inaccurate or negative thinking so they can respond to challenging situations in a more effective way. GET is a structured exercise program that aims to gradually increase how long a patient can carry out physical activity.

For this study, Dr. Sharpe and team followed up with CFS patients who took part in a study published in 2011 (the PACE trial) to see how they were fairing 2.5 years after starting treatment. Three quarters of the original 641 patients took part in the follow-up through a survey.

Dr. Sharpe and team found that the improvements in fatigue and physical function seen after one year in the PACE trial with CBT and GET were maintained in the long-term.

Patients who received CBT or GET in the trial were also less likely to seek additional therapy after one year than those who received SMC or APT.

Dr. Sharpe and colleagues found no significant differences between the four treatment groups in long-term deterioration of general health.

"Finding no significant differences in the proportions getting worse over time is a reassurance for those who worry that some of these treatments might make things worse," said study author Peter D. White, MD, a professor of psychological medicine at Queen Mary University of London, in a press release. "But it is also a reminder that these treatments do not help everybody, and more research is needed into finding other treatments that help."

This study was published online Oct. 28 in the journal The Lancet Psychiatry.

The UK Medical Research Council, the Department of Health for England and the Scottish Chief Scientist Office, among others, funded this research.

Several study authors disclosed potential conflicts of interest.

Review Date: 
October 29, 2015
Last Updated:
November 2, 2015