Harvard Mental Health Letter

In brief: Cognitive behavioral therapy for chronic fatigue syndrome

In Brief

Cognitive behavioral therapy for chronic fatigue syndrome

A review by the Cochrane Collaboration concludes that cognitive behavioral therapy (CBT) may be an effective treatment for chronic fatigue syndrome, a sometimes disabling condition that results in extreme and persistent lack of energy. Although the disorder is heterogeneous, CBT may help teach many patients to recognize and change negative thinking that may impair recovery.

The reviewers analyzed 15 studies involving 1,043 patients who had chronic fatigue syndrome for an average of almost five years. Overall, studies that compared CBT with control groups found that 40% of patients who underwent CBT reported feeling less fatigued, compared with 26% of patients receiving usual community care or on a waiting list for care. These results held up one to seven months later in patients who attended all CBT sessions, but not for those who had dropped out at some point.

Studies comparing CBT with other psychological therapies, such as relaxation techniques, counseling, and education, also indicate CBT may be more likely to reduce fatigue and other symptoms — but the results were not as clear as those that compared CBT to usual care. And the review indicates that CBT was no better than exercise at reducing fatigue.

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