Patients with chronic fatigue syndrome benefit from cognitive behavior therapy

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Researchers from Amsterdam UMC and King’s College London have shown that cognitive behavioral therapy (CBT) is beneficial for people with ME/CFS. They analyzed data from studies involving almost 1,300 patients and found that CBT led to a reduction in fatigue and physical limitations. These results are published today in Psychological Medicine.

We found that CBT led to a clinically relevant reduction in fatigue and functional limitations, as well as an increase in physical functioning. These results provide a clear picture that CBT can be beneficial for a significant number of patients. About half were no longer seriously tired after treatment.”

Professor Hans Knoop, clinical psychologist at Amsterdam UMC and leader of the research group

Who benefits?

It is often assumed that patients who experience an increase in symptoms after exercise, known as post-exertional malaise (PEM), do not benefit from CBT or even that CBT worsens their symptoms. The researchers sought to determine which patients CBT was beneficial for. They found that patients could benefit from cognitive behavioral therapy, regardless of what symptoms they experienced or how ME/CFS was diagnosed.

There were differences between patients in the extent to which they benefited from CBT: younger patients, patients with less functional limitations and patients who were still relatively active benefited more from CBT.

“Reporting more functional limitations and being physically inactive may indicate a more serious illness and this subgroup of patients is likely to require additional or more intensive treatment,” says Tanja Kuut, clinical psychologist at Amsterdam UMC and lead author of this study.

Findings contradict guidelines

In 2021, NICE, the British National Institute of Clinical Excellence, published new guidelines for ME/CFS. In addition to proposing a new case definition for ME/CFS, they concluded that CBT can only support patients in managing symptoms, but cannot be viewed as a treatment that can reduce symptoms and promote recovery. can promote. This conclusion was partly based on the lack of evidence for the efficacy of CBT when certain (new) case definitions of ME/CFS were used to diagnose ME/CFS or when PEM was reported by patients.

The findings of the new study show that CBT can also be effective for patients with PEM and for those diagnosed using the new case definitions. In the eyes of Knoop and Kuut, this is encouraging news for patients and provides guidance for healthcare providers who were unsure which patients to refer to CBT.


Amsterdam University Medical Centers

Magazine reference:

Six, TA, et al. (2023) Does the effect of cognitive behavioral therapy in chronic fatigue syndrome (ME/CFS) vary depending on patient characteristics? A systematic review and meta-analysis of individual patient data. Psychological medicine.

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