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Cited by 528Fibromyalgia and Chronic Fatigue Syndrome ResearchLong-Term Effects of COVID-19Musculoskeletal pain and rehabilitation

Cognitive behaviour therapy for the chronic fatigue syndrome: a randomised controlled trial.

Open access
Sharpe, Michael, Hawton, Keith, Simkin, Sue, Surawy, Christina, Hackmann, Ann, Klimes, Ivana, Peto, Tim, Warrell, David +1 more·1996·BMJ
DOI 10.1136/bmj.312.7022.22PMC PMC2349693
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Abstract

Abstract Objective : To evaluate the acceptability and efficacy of adding cognitive behaviour therapy to the medical care of patients presenting with the chronic fatigue syndrome. Design : Randomised controlled trial with final assessment at 12 months. Setting : An infectious diseases outpatient clinic. Subjects : 60 consecutively referred patients meeting consensus criteria for the chronic fatigue syndrome. Interventions : Medical care comprised assessment, advice, and follow up in general practice. Patients who received cognitive behaviour therapy were offered 16 individual weekly sessions in addition to their medical care. Main outcome measures : The proportions of patients (a) who achieved normal daily functioning (Karnofsky score 80 or more) and (b) who achieved a clinically significant improvement in functioning (change in Karnofsky score 10 points or more) by 12 months after randomisation. Results : Only two eligible patients refused to participate. All randomised patients completed treatment. An intention to treat analysis showed that 73% (22/30) of recipients of cognitive behaviour therapy achieved a satisfactory outcome as compared with 27% (8/30) of patients who were given only medical care (difference 47 percentage points; 95% confidence interval 24 to 69). Similar differences were observed in subsidiary outcome measures. The improvement in disability among patients given cognitive behaviour therapy continued after completion of therapy. Illness beliefs and coping behaviour previously associated with a poor outcome changed more with cognitive behaviour therapy than with medical care alone. Conclusion : Adding cognitive behaviour therapy to the medical care of patients with the chronic fatigue syndrome is acceptable to patients and leads to a sustained reduction in functional impairment. Key messages Key messages There is no generally accepted form of treatment New findings show that patients referred to hospital for the chronic fatigue syndrome have a better outcome if they are given a course of cognitive behaviour therapy than if they receive only basic medical care Clinical improvement with cognitive behaviour therapy may be slow but often continues after treatment has ended Cognitive behaviour therapy should be considered as an option for patients presenting with the chronic fatigue syndrome

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  • CBT has been adapted and tested with CFS patients yielding superior results compared to standard medical treatment, relaxation, and adaptive pacing therapy, with moderate effect sizes (d = 0.48).

    “CBT has been adapted and tested with CFS patients yielding superior results compared to standard medical treatment, relaxation, and adaptive pacing therapy (Sharpe et al., 1996; Deale et al., 1997; White et al., 2011), with moderate effect sizes (d = 0.48) (Malouff et al., 2008).”

    From The relationship between improvement in insomnia severity and long-term outcomes in the treatment of chronic fatigue (2018) · cites this paper as Sharpe et al., 1996

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Research works printed but not linked: 2

  1. 19 Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: Guilford Press, 1979.
  2. 20 Karnofsky DA, Abelmann WH, Craver LF, Burchenal JH. The use of the nitrogen mustards in the palliative treatment of carcinoma. Cancer 1948;1: 634-56.

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Authors
Sharpe, M., Hawton, K., Simkin, S., Surawy, C., Hackmann, A., Klimes, I., Peto, T., Warrell, D., & Seagroatt, V.
Affiliations
  • Warneford Hospital (GB)
  • John Radcliffe Hospital (GB)
  • University of Oxford (GB)
ORCID
Venue
BMJ
Publisher
BMJ
Published
1996-01-06
Volume
312
Issue
7022
Pages
22-26
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.312.7022.22
PMC
PMC2349693
OpenAlex
W2023718291
Cited by
528
References
27
Citations by year
2026: 2 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 1 · 2020: 7 · 2019: 7 · 2018: 3 · 2017: 9 · 2016: 7 · 2015: 14 · 2014: 11 · 2013: 14 · 2012: 19
FWCI
47.30
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Wellcome Trust
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 › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
chronic fatigue syndrome, cognitive behavioral therapy, health care, functional disability, Karnofsky performance status, illness beliefs, coping behaviour, treatment acceptability, treatment efficacy
MeSH terms
Adaptation, Psychological, Adult, Attitude to Health, Depression, Female, Humans, Male, Patient Compliance, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Treatment Outcome

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