Cognitive behaviour therapy for chronic fatigue syndrome in adults.

Price JR, Mitchell E, Tidy E, Hunot V.

The objective of this study was to examine the effectiveness and acceptability of CBT for CFS, alone and in combination with other interventions, compared with usual care and other interventions. Fifteen studies (1043 CFS participants) were included in the review. When comparing CBT with usual care the difference in fatigue mean scores at post-treatment was highly significant in favour of CBT , with 40% of CBT participants showing clinical response in contrast with 26% in usual care. Findings at follow-up were inconsistent. For CBT versus other psychological therapies, comprising relaxation, counselling and education/support the difference in fatigue mean scores at post-treatment favoured CBT. Findings at follow-up were heterogeneous and inconsistent. Only two studies compared CBT against other interventions and one study compared CBT in combination with other interventions against usual care.

CBT is effective in reducing the symptoms of fatigue at post-treatment compared with usual care, and may be more effective in reducing fatigue symptoms compared with other psychological therapies. The evidence base at follow-up is limited to a small group of studies with inconsistent findings. There is a lack of evidence on the comparative effectiveness of CBT alone or in combination with other treatments, and further studies are required to inform the development of effective treatment programmes for people with CFS.

Cochrane Database Syst Rev. 2008 Jul 16;(3):CD001027.

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