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Cited by 509Fibromyalgia and Chronic Fatigue Syndrome ResearchLong-Term Effects of COVID-19Traumatic Brain Injury Research

Interventions for the Treatment and Management of Chronic Fatigue Syndrome: A Systematic Review

Whiting, Penny, Bagnall, Anne-Marie, Sowden, Amanda J., Cornell, John E., Mulrow, Cynthia D., Ramírez, Gilbert·2001·JAMA
DOI 10.1001/jama.286.11.1360
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Abstract

CONTEXT: A variety of interventions have been used in the treatment and management of chronic fatigue syndrome (CFS). Currently, debate exists among health care professionals and patients about appropriate strategies for management. OBJECTIVE: To assess the effectiveness of all interventions that have been evaluated for use in the treatment or management of CFS in adults or children. DATA SOURCES: Nineteen specialist databases were searched from inception to either January or July 2000 for published or unpublished studies in any language. The search was updated through October 2000 using PubMed. Other sources included scanning citations, Internet searching, contacting experts, and online requests for articles. STUDY SELECTION: Controlled trials (randomized or nonrandomized) that evaluated interventions in patients diagnosed as having CFS according to any criteria were included. Study inclusion was assessed independently by 2 reviewers. Of 350 studies initially identified, 44 met inclusion criteria, including 36 randomized controlled trials and 8 controlled trials. DATA EXTRACTION: Data extraction was conducted by 1 reviewer and checked by a second. Validity assessment was carried out by 2 reviewers with disagreements resolved by consensus. A qualitative synthesis was carried out and studies were grouped according to type of intervention and outcomes assessed. DATA SYNTHESIS: The number of participants included in each trial ranged from 12 to 326, with a total of 2801 participants included in the 44 trials combined. Across the studies, 38 different outcomes were evaluated using about 130 different scales or types of measurement. Studies were grouped into 6 different categories. In the behavioral category, graded exercise therapy and cognitive behavioral therapy showed positive results and also scored highly on the validity assessment. In the immunological category, both immunoglobulin and hydrocortisone showed some limited effects but, overall, the evidence was inconclusive. There was insufficient evidence about effectiveness in the other 4 categories (pharmacological, supplements, complementary/alternative, and other interventions). CONCLUSIONS: Overall, the interventions demonstrated mixed results in terms of effectiveness. All conclusions about effectiveness should be considered together with the methodological inadequacies of the studies. Interventions which have shown promising results include cognitive behavioral therapy and graded exercise therapy. Further research into these and other treatments is required using standardized outcome measures.

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Authors
Whiting, P., Bagnall, A.-M., Sowden, A. J., Cornell, J. E., Mulrow, C. D., & Ramírez, G.
Affiliations
  • University of York (GB)
  • The University of Texas at San Antonio Health Science Center (US)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2001-09-19
Volume
286
Issue
11
Pages
1360
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.286.11.1360
OpenAlex
W2069446085
Cited by
509
References
49
Citations by year
2026: 2 · 2025: 13 · 2024: 8 · 2023: 3 · 2022: 9 · 2021: 11 · 2020: 7 · 2019: 13 · 2018: 11 · 2017: 18 · 2016: 15 · 2015: 22 · 2014: 14 · 2013: 17 · 2012: 13
FWCI
28.66
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (290-97-0012)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
chronic fatigue syndrome, therapeutic interventions, graded exercise therapy, cognitive behavioral therapy, immunoglobulins, cortisol, immunotherapy, behavior therapy, pharmacotherapy, complementary and alternative medicine, supplements, treatment effectiveness, outcome measures
MeSH terms
Adult, Complementary Therapies, Child, Clinical Trials as Topic, Exercise Therapy, Humans, Immunotherapy, Outcome and Process Assessment, Health Care, Reproducibility of Results, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Dietary Supplements

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