title: A preliminary prospective study of nutritional, psychological and combined therapies for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in a private care setting.
abstract: BACKGROUND
  Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a condition characterised by severe and persistent fatigue, neurological disturbances, autonomic and endocrine dysfunctions and sleep difficulties that have a pronounced and significant impact on individuals' lives. Current National Institute for Health and Clinical Excellence guidelines within the UK suggest that this condition should be treated with cognitive behavioural therapy and/or graded exercise therapy, where appropriate. There is currently a lack of an evidence base concerning alternative techniques that may be beneficial to those with ME/CFS.
  
  
  OBJECTIVE
  This study aimed to investigate whether three modalities of psychology, nutrition and combined treatment influenced symptom report measures in those with ME/CFS over a 3-month time period and whether there were significant differences in these changes between groups.
  
  
  METHODS
  This is a preliminary prospective study with one follow-up point conducted at a private secondary healthcare facility in London, UK.
  
  
  METHODS
  138 individuals (110 females, 79.7%; 42 participants in psychology, 44 in nutrition and 52 in combined) participated at baseline and 72 participants completed the battery of measures at follow-up (52.17% response rate; 14, 27 and 31 participants in each group, respectively).
  
  
  METHODS
  Self-reported measures of ME/CFS symptoms, functional ability, multidimensional fatigue and perceived control.
  
  
  RESULTS
  Baseline comparisons showed those in the combined group had higher levels of fatigue. At follow-up, all groups saw improvements in fatigue, functional ability and symptomatology; those within the psychology group also experienced a shift in perceived control over time.
  
  
  CONCLUSIONS
  This study provides early evidence that psychological, nutritional and combined techniques for the treatment of ME/CFS may influence symptomatology, fatigue, function and perceived control. However, these results must be viewed with caution as the allocation to groups was not randomised, there was no control group and the study suffered from high drop-out rates.
authors.affiliation: Department of Research, The Optimum Health Clinic, London, UK.
authors.forename: Megan Anne
authors.initials: MA
authors.lastname: Arroll
authors.forename: Alex
authors.initials: A
authors.lastname: Howard