Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial

doi:10.1136/bmj.38301.587106.63

BMJ 2005;330:14 (1 January), doi:10.1136/bmj.38301.587106.63 (published 7 December 2004)

Paper

Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial

Maja Stulemeijer, junior researcher¹, Lieke W A M de Jong, child psychologist², Theo J W Fiselier, paediatrician³, Sigrid W B Hoogveld, junior researcher¹, Gijs Bleijenberg, professor of psychology¹

¹ Expert Centre Chronic Fatigue, University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Netherlands, ² Department of Medical Psychology, University Medical Centre Nijmegen, ³ Department of Paediatrics, University Medical Centre Nijmegen

Correspondence to: G Bleijenberg G.Bleijenberg{at}nkcv.umcn.nl

Objective To evaluate the efficacy of cognitive behaviour therapyfor adolescents aged 10-17 years with chronic fatigue syndrome.

Design Randomised controlled trial.

Setting Department of child psychology.

Participants 71 consecutively referred patients with chronicfatigue syndrome; 36 were randomly assigned to immediate cognitivebehaviour therapy and 35 to the waiting list for therapy.

Intervention 10 sessions of therapy over five months. Treatmentprotocols depended on the type of activity pattern (relativelyactive or passive). All participants were assessed again afterfive months.

Main outcome measures Fatigue severity (checklist individualstrength), functional impairment (SF-36 physical functioning),and school attendance.

Results 62 patients had complete data at five months (29 inthe immediate therapy group and 33 on the waiting list). Patientsin the therapy group reported significantly greater decreasein fatigue severity (difference in decrease on checklist individualstrength was 14.5, 95% confidence interval 7.4 to 21.6) andfunctional impairment (difference in increase on SF-36 physicalfunctioning was 17.3, 6.2 to 28.4) and their attendance at schoolincreased significantly (difference in increase in percentageschool attendance was 18.2, 0.8 to 35.5). They also reporteda significant reduction in several accompanying symptoms. Selfreported improvement was largest in the therapy group.

Conclusion Cognitive behaviour therapy is an effective treatmentfor chronic fatigue syndrome in adolescents.

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Rapid Responses:

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If a treatment helps some patients, should it be described as being "effective" for that condition?: Tom P Kindlon
bmj.com, 13 Dec 2004 [Full text]
Concerns regarding this paper.: Angela P. Kennedy
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Re criteria and 'effective' ain't wot it used to be: Ellen Goudsmit
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Re: Re criteria and 'effective' ain't wot it used to be: Angela P Kennedy
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A Bridge Too Far: Erik R Johnson
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Re: Re: Re criteria and 'effective' ain't wot it used to be: Ellen Goudsmit
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Ideological assumptions influence choice of criteria: Angela P Kennedy
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Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: Douglas T Fraser
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Insufficient data, inappropriate conclusion: Abhijit Chaudhuri
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Question for the Statistical Advisors of the BMJ: Bart Stouten
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Accidental or Deliberate Denigration of ME?: Angela Flack
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Re: Re: Insufficient data, inappropriate conclusion: Angela Kennedy
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CBT, peer pressure and wishful thinking: Ken S Linder
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Re: Question for the Statistical Advisors of the BMJ: Maja Stulemeijer, et al.
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PACE: Erik R Johnson
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Nutritional deficiencies, especially in female adolescents, with chronic fatigue syndrome: Ellen C G Grant
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CBT has a Cohen's d value of 0.31 in this study: Tom Kindlon
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Re: CBT has a Cohen's d value of 0.31 in this study: Tom Kindlon
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CFS-Psycho: Ian Hodgson
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