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Review: CBT reduces fatigue in adults with chronic fatigue syndrome but effects at follow-up unclear

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How effective is cognitive behavioural therapy (CBT) for chronic fatigue syndrome (CFS) in adults?


Fatigue severity (measured on the Chalder Fatigue Scale or any other validated fatigue scale); clinical response (as defined by trial authors based on diagnostic interview or specified cut-off on validated scales).



Systematic review with meta-analysis.

Data sources:

The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (CCDANCTR), Cochrane Central Register of Controlled Trials and the Index to Theses of Great Britain and Ireland were initially searched in 2006, and the search of CCDANCTR updated in March 2008. Ongoing trials were identified by searching clinical trial websites in January 2007. Further studies were identified by hand searching reference lists of relevant articles and by contacting experts in the field.

Study selection and analysis:

Two reviewers assessed the studies; differences were resolved by a third reviewer. For inclusion, the study had to be an RCT comparing CBT (alone or with other interventions) versus usual care or other intervention; to include at least 90% of participants who met specified diagnostic criteria for CFS; and include only adults (aged 17 years and above) (see online notes for further details).


Included studies: 15 …

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  • Source of funding: The Wellcome Trust, Medical Research Council, Oxford and Anglia NHS Research and Development Directorate, Department of Health, University of Oxford, Department of Psychiatry, and Institute of Psychiatry, King's College London, UK.


  • Competing interests: AMS was a member of the NICE guideline development group on the diagnosis and management of CFS/myalgic encephalomyelitis.

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