BMJ 1996;312:1097 (27 April)

Letters

Use an interdisciplinary approach

EDITOR,--From their randomised trial in the chronic fatigue syndrome Michael Sharpe and colleagues conclude that cognitive behaviour therapy is more effective than "medical care" in improving day to day function.1 It is not clear that the data presented justify this conclusion.

Firstly, the authors do not compare like with like: the group given cognitive behaviour therapy received 16 hours of therapy while the "medical" group received no intervention. Secondly, the "medical" group of patients were "advised to increase their level of activity by as much as they felt able," which may have had adverse effects if the activity was unsupervised and inappropriate.2 This could have affected the results by making the group given cognitive behaviour therapy seem to improve by more than they did. Thirdly, all patients, and particularly those with the chronic fatigue syndrome, need detailed discussion of their problems. Many doctors will not have been aware that in . . . [Full text of this article]


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Relevant Article

Cognitive behaviour therapy for the chronic fatigue syndrome: a randomised controlled trial
Michael Sharpe, Keith Hawton, Sue Simkin, Christina Surawy, Ann Hackmann, Ivana Klimes, Tim Peto, David Warrell, and Valerie Seagroatt
BMJ 1996 312: 22-26. [Abstract] [Full Text]

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