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CBT could be treatment option for chronic fatigue

Cognitive behaviour therapy (CBT) can be used to treat patients with chronic fatigue syndrome, according to Cochrane Researchers.

There is no widely accepted explanation for the disease, which is estimated to affect up to one in 100 of the population, and patients are currently offered a variety of different treatments.

A review of 15 studies, including a total of 1,043 patients, compared CBT with either usual care or other psychological therapies. It found CBT to be more effective in reducing the severity of symptoms than the other therapies or standard care.

However, the reviewers say further research is required to determine whether CBT is more beneficial than other forms of treatment, such as exercise and relaxation therapies.

Lead researcher Jonathan Price, from the University of Oxford, said: ‘CFS is a challenging illness for patients, and there is ongoing controversy about its causes. There remain unanswered questions, but the available evidence is clear – CBT can help many people with CFS.’


Readers' comments (8)

  • CBT may help people with garden-variety chronic fatigue. It does NOT reduce the severity of symptoms of chronic fatigue SYNDROME, which is an organic disease.

    Put it this way: sending a CFS patient to a therapist is much like sending someone with multiple sclerosis to a therapist. At best, it can help the person cope with the emotional difficulties of living with a (so far) incurable disease. It's not going to ameliorate the physical symptoms.

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  • you sound as though that you know what chronic fatigue syndrome is.How do you know.

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  • Since 1969 the World Health Organisation has defined M.E./CFS as a neurological illness.Tragically for sufferers, it remains the only neurological illness treated in the UK solely by psychiatric means - graded exercise and cognitive behaviour 'therapies', both of which have been repeatedly proven to make the illness as defined by the WHO worse. Some patients with genuine ME have been left bedbound by this inappropriate treatment. One young woman, Sophie Mirza, recently died of ME after being sectioned under the mental health act. At autopsy she was found to have unequivocal inflammatory changes affecting her dorsal root ganglia similar to that seen during active infection by herpes viruses. Casey Faro, who died of ME aged 23 was found at autopsy to have myocarditis 'not of a new onset'. No government funding has ever gone to researching physical causes or treatments;strangely, all funding has gone to psychiatrists. Research results such as this study are only possible because in the UK the term 'CFS' has been widened to include patients with many different illnesses that have fatigue as a symptom, including psychiatric disorders. These are the patients who are progressing on the present regime of CBT & GET whilst ME patients continue with undiagnosed & untreated viruses,parasites,heart conditions etc. For the 25% of ME sufferers who are severely affected CBT is a sick joke.

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  • M.E./CFS is not a mental condition, it is a neurological illness & CBT has been repeatedly found by patient group surveys to worsen the already debilitating symptoms.There is overwhelming research evidence proving it is a physical illness. 80% of sufferers never recover, & some live their lives in darkened rooms unable to speak or swallow. It is time that the nursing profession stopped colluding with the powerful psychiatric lobby that have redefined M.E. as a somatisation disorder to their own personal gain. This redefinition makes sufferers already difficult lives impossible. It is not acceptable enough in 2008 for the nursing profession to 'just follow orders' in the treatment of M.E. patients as if they have a mental illness.
    ME/CFS is an acquired organic, pathophysiological, multi-systemic illness that occurs in both sporadic and epidemic forms. Myalgic Encephalomyelitis (ICD 10 G93.3), which includes CFS, is classified as a neurological disease in the World Health Organization's International Classification of Diseases (ICD). Chronic fatigue must not be confused with ME/CFS because the "fatigue" of ME/CFS represents pathophysiological exhaustion and is only one of many symptoms. Compelling research evidence of physiological and biochemical abnormalities identifies ME/CFS as a distinct, biological clinical disorder.

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  • The evidence is far from as clear as Psychiatrist Jonathan Price asserts it is can help many people with CFS.

    It's unclear: whether he is including M.E. (Myalgic Encephalomyelitis) in this catch-all diagnosis but this disabling neurological illness should not be bundled with other illnesses which have chronic fatigue as a symptom because they are not the same, should not be treated the same and, if he is, the statistics will be distorted; what kind of treatment regime they actually receive; how long for; whether in conjunction with another treatment such as drugs or Graded Exercise Treatmant (GET) which are potentially addictive, irrecoverably harmful and confound the statistics.

    When therapists - or, sometimes, the patients themselves -claim that CBT has helped their CFS, there are always other possible explanations, such as improvement with time, resting or pacing, which CBT advocates choose to ignore or overrule.

    This month, at a Conference at the University of East Anglia, Professors Mick Cooper & Robert Elliott from Strathclyde University showed that the efficacy of CBT is a 'myth' and we are probably wasting millions of pounds

    Jonathan Price seems to be looking into a very different pool - or with different tinted lenses - if he sees clear evidence where other researchers and patients see very muddy waters indeed

    Dr John H Greensmith
    ME Free For All. org

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  • I am a psychiatrc nurse however I am also the Mother of a daughter who was given a diagnosis of M.E. I agree with the response that not enough research is being done to find the psychical cause of M.E and inded all the money is being given to psychiatry. I am a beleiver in C.B.T for anxiety, mild depression and many other disorders. I strongly believe although C.B.T can be helpful in the thinking process about how the person copes with the symptoms M.E should belong to the medical profession and lets hope the magical breakthrough in research can find the answer

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  • My daughter who has severe ME has attended 25 CBT sessions. It has helped her to deal with the depression caused by this awful disease but it has definitely caused deterioration in her ME symptoms which in turn brought the depression back, as strong as ever. Overall- drawbacks outweigh the benefits manifold.

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  • Joanna Ko: Can you tell us what part of CBT actually made your daughter worse, as opposed to simply not helping her symptoms? Was graded exercise therapy involved, or was it simply the difficulty of traveling to her appointments -- not trivial for someone with this illness.

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