Possible Detrimental Effects of Cognitive Behaviour Therapy for Chronic Fatigue Syndrome
Abstract
Background: Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) can decrease the level of fatigue and disabilities, but it has been suggested that during therapy some patients experience a deterioration of their symptoms rather than an improvement. The aim of this study is to examine the frequency and severity of symptom deterioration during CBT for CFS. Methods: Data from 3 randomised controlled trials on CBT for CFS were pooled and reanalysed. Symptom deterioration during the trial was rated by patients and measured as deterioration in fatigue, pain, functional impairment and psychological distress. Both the frequency and severity of deterioration in these domains were compared between the patients receiving CBT and those in the control group. Predictors of symptom deterioration were identified by comparing their means in patients with and without an increase in fatigue. Statistically significant predictors were then combined in a logistic regression model. Results: The frequency of symptom deterioration varied from 2 to 12% in patients receiving CBT and from 7 to 17% in the control group. None of the measures showed a significantly higher frequency of symptom deterioration in the CBT group. The severity of deterioration was also comparable in the CBT and in the control group. No predictors of symptom deterioration specific to CBT were found. Conclusion: Patients receiving CBT do not experience more frequent or more severe symptom deterioration than untreated patients. The reported deterioration during CBT seems to reflect the natural variation in symptoms. Thus, CBT is not only a helpful, but also a safe treatment for CFS.
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The recently published individual patient data meta-analysis in CBT for CFS had a data base limited to a specific treatment-protocol and was therefore less generalizable.
“While there is a recently published individual patient data meta-analysis in CBT for CFS [49], the data base for that project was limited to a specific treatment-protocol (e.g., [50]) and therefore less generalizable.”
From Efficacy and Acceptance of Cognitive Behavioral Therapy in Adults with Chronic Fatigue Syndrome: A Meta-analysis. (2024) · cites this paper as [50]
Patients' scoring of their QoL after treatment is closely related to their operationalization of the concept of 'recovery'.
“patients scoring their QoL after treatment is closely related to their operationalization of the concept of 'recovery'”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [56]
The operationalization of 'recovery' can change during psychological treatment.
“this operationalization can change eventually during psychological treatment [4,56].”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [56]
It is possible that natural variation in outcomes occurs independently of treatment.
“It may thus be possible that natural variation in outcomes occurs independently of treatment [56].”
From Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. (2013) · cites this paper as [56]
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- Authors
- Heins, M. J., Knoop, H., Prins, J. B., Stulemeijer, M., van der Meer, J. W. M., & Bleijenberg, G.
- Affiliations
- Radboud University Medical Center (NL)
- VieCuri Medisch Centrum (NL)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2010
- Volume
- 79
- Issue
- 4
- Pages
- 249-256
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W2043503304
- Cited by
- 47
- References
- 34
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 6 · 2014: 3 · 2013: 4 · 2012: 5
- FWCI
- 4.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- 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, cognitive behavioral therapy, symptom deterioration, fatigue, pain, functional disability, psychological distress, treatment safety
- MeSH terms
- Adolescent, Adult, Child, Female, Humans, Male, Self-Help Groups, Severity of Illness Index, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Odds Ratio, Age Distribution
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