Harvard Mental Health Letter

In Brief: Study suggests cognitive behavioral therapy may help with chronic fatigue syndrome but is no panacea

A study adds to the evidence 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. But the study also suggests that the benefits are modest at best.

In the PACE trial, researchers in London randomly assigned 641 participants to specialist medical care alone (delivered by clinicians experienced at treating chronic fatigue syndrome) or combined with CBT, a moderate exercise program, or adaptive pacing therapy. (This last option, which also provided the study with its name, teaches patients how to reduce fatigue by adjusting their lifestyle and activity levels.) Participants underwent their assigned therapy for six months and answered questions about fatigue and physical functioning at the beginning, middle, and end of the study, as well as at 52 weeks (to assess follow-up).

The researchers found that both regular moderate exercise and CBT — when combined with medical care from chronic fatigue specialists — were more effective than medical care alone at reducing fatigue and improving physical function. Contrary to the researchers' expectations, however, adaptive pacing therapy proved no better than specialist medical care alone.

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