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Do more people recover from chronic fatigue syndrome with cognitive behaviour therapy or graded exercise therapy than with other treatments?

, , , &
Pages 57-61
Received 25 Jan 2017
Accepted 26 Jan 2017
Published online: 15 Feb 2017
 

ABSTRACT

Background: Wilshire et al. suggest that we have overestimated the number of patients that recover from chronic fatigue syndrome (CFS) after receiving a course of either cognitive behaviour therapy (CBT) or graded exercise therapy (GET), as reported in a secondary analysis of outcome data from the Pacing, graded Activity and Cognitive behavior therapy; a randomized Evaluation (PACE) trial. We provide counter-arguments to this view.

Purpose: To provide an alternative view to that offered by Wilshire et al.

Methods: We review the two different analyses of PACE trial outcome data to estimate recovery, and compare these to other published trials and cohort studies.

Results: While there is no gold standard for recovery from CFS, previous trials and cohort studies provide support for our analysis of recovery in the PACE trial. Our finding that 22% of participants recover from the current episode of CFS after either CBT or GET, compared to 8% after adaptive pacing therapy and 7% after specialist medical care alone, is consistent with the literature.

Conclusions: Our original conclusions that ‘ … recovery from CFS is possible, and that CBT and GET are the therapies most likely to lead to recovery’ is an important, reasonable, and hopeful message for both clinicians and patients.

Disclosure statement

PDW is a member of the Independent Medical Experts Group, a non-department public body, which advises the UK Ministry of Defence regarding the Armed Forces Compensation Scheme. He does paid consultancy for a re-insurance company. MS has received royalties from several publishers of academic books. TC has received royalties from a book regarding self-help for CFS. ALJ and KAG have no conflicts of interest.

Additional information

Funding

Funding for this trial was received from: UK Medical Research Council, the Department of Health for England, the Department for Work and Pensions, and the Scottish Chief Scientist Office.

Notes on contributors

M. Sharpe

M. Sharpe, M.D. is Professor of Psychological Medicine at the University of Oxford.

T. Chalder

T. Chalder, Ph.D. is Professor of Cognitive Behavioural Psychotherapy at Kings College London.

A. L. Johnson

A. L. Johnstone, Ph.D. is Senior Statistician at the MRC Clinical Trials Unit at University College London.

K. A. Goldsmith

K. A. Goldsmith, Ph.D. is Senior Lecturer in Statistics at Kings College, London.

P. D. White

P. D. White, M.D. is Emeritus Professor of Psychological Medicine at Queen Mary, University of London.

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