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

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Sharpe, Michael, Hawton, Keith, Simkin, Sue, Surawy, Christina, Hackmann, Ann, Klimes, Ivana, Peto, Tim, Warrell, David, Seagroatt, Valerie·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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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: Sharpe, Michael
Hawton, Keith
Peto, Tim
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: green
www.ncbi.nlm.nih.gov
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 › Clinical Neurology › Long-Term Effects of COVID-19
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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Cognitive behaviour therapy for the chronic fatigue syndrome: a randomised controlled trial.

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