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CBT and exercise therapy effective for CFS

By Christian Duffin

A study comparing different treatments for chronic fatigue syndrome has reignited a debate about the effectiveness and safety of different treatments for chronic fatigue syndrome.

Patient organisations have reported that cognitive behavioural therapy and exercise therapy can be harmful, and prefer pacing therapy, which involves an assessment of people's daily activities and a programme of rest balanced with activity, and specialist care.

Researchers conducted a randomised controlled trial that allocated 160 patients with adaptive pacing therapy (APT), 161 to cognitive behavioural therapy, 160 to graded exercise therapy (GET) and 160 to specialist care only.

Participants subsequently filled in questionnaires, enabling researchers to calculate a ‘mean fatigue score.'

After one year the scores, compared with SMC alone, were 3.4 points lower for the CBT group and 3.2 points lower for the GET group, but were not significantly different for the APT group.

Similarly, physical function scores were 7.1 points higher and CBT and 9.4 points higher in the GET groups, but not significantly different among the APT group.

Lead researcher professor Peter White, a professor of psychological medicine at Queen Mary University of London, said: ‘CBT and GET can safely be added to SMC to moderately improve outcomes for chronic fatigue syndrome, but APT is not an effective addition.'

The Lancet 2011, published online 17 Feb

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