Abstract

Andrew P. Smith* and Marie Thomas

ABSTRACT

Background: Cognitive Behaviour Therapy (CBT) has been recommended as a suitable treatment for chronic fatigue syndrome (CFS). However, recently it has been suggested that the efficacy of CBT is limited, and there is little evidence that it changes objective outcomes. Objectives: The aim of the present analyses were to determine whether group CBT changed the mood and cognitive performance of CFS patients. CBT was compared to two conditions from the same study, namely education and support and standard medical care. Further analyses compared these conditions with a longitudinal study of untreated CFS patients, healthy controls and those having Multi-Convergent Therapy (MCT). Methods: CFS patients were referred to a pain management clinic and randomly assigned to CBT (N=53), education and support (N=49) or standard medical care (N=49). Mood and cognitive performance were measured pre-treatment and again at six and twelve months post-treatment. Comparisons were also made with a sample of untreated CFS patients (N = 195) and those who had participated in a study of MCT (N=35). Results: At baseline, the CFS patients showed the usual differences from healthy controls, namely a more negative mood, slower reaction times, and impaired recall and sustained attention. Analyses of the post-treatment data revealed little evidence of CBT leading to significant changes. In contrast, MCT was associated with significant improvements in mood and performance. Conclusions: Group CBT leads to a significant reduction in subjective symptoms but does not improve cognitive performance, whereas individual MCT does improve mood and performance.