Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome?
BACKGROUND
Cognitive behavioural therapy (CBT) for chronic fatigue syndrome (CFS) leads to a decrease in symptoms and disabilities. There is controversy about the nature of the change following treatment; some suggest that patients improve by learning to adapt to a chronic condition, others think that recovery is possible. The objective of this study was to find out whether recovery from CFS is possible after CBT.


METHODS
The outcome of a cohort of 96 patients treated for CFS with CBT was studied. The definition of recovery was based on the absence of the criteria for CFS set up by the Center for Disease Control (CDC), but also took into account the perception of the patients' fatigue and their own health. Data from healthy population norms were used in calculating conservative thresholds for recovery.


RESULTS
After treatment, 69% of the patients no longer met the CDC criteria for CFS. The percentage of recovered patients depended on the criteria used for recovery. Using the most comprehensive definition of recovery, 23% of the patients fully recovered. Fewer patients with a co-morbid medical condition recovered.


CONCLUSIONS
Significant improvement following CBT is probable and a full recovery is possible. Sharing this information with patients can raise the expectations of the treatment, which may enhance outcomes without raising false hopes.
Knoop
Hans
H
Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. j.knoop@nkcv.umcn.nl
Bleijenberg
Gijs
G
Gielissen
Marieke F M
MF
van der Meer
Jos W M
JW
White
Peter D
PD
D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012803:Sick Role; D012917:Social Adjustment