Chronic Fatigue Syndrome: Pessimism Doesn't Help

Two behaviorally based therapies perform better than adaptive pacing therapy, but response remains suboptimal.

Several treatments have been suggested for chronic fatigue syndrome (CFS). Cognitive-behavior therapy (CBT) focuses on patients' fears that activity would induce exacerbations. Graded exercise therapy (GET) addresses patients' deconditioning and activity avoidance by gradually increasing exercise. Some patient advocacy groups recommend “adaptive pacing therapy” (APT), which assumes that patients should not exceed an “energy envelope” but should instead adapt to the illness by reducing and prioritizing activities. This multicenter, randomized study compared efficacy of CFS specialist medical care (SMC; mainly, advice and pharmacotherapy; ≥3 sessions in 12 months) alone or added to APT, CBT, or GET (≤14 sessions in 23 weeks, optional “booster…

Reviewing Author

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Chronic Fatigue Syndrome: Pessimism Doesn't Help

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Reviewing Author