BMJ 1996;312:1097 (27 April)

Letters

Essential elements of the treatment must be identified

EDITOR,--We have several practical and theoretical concerns about Michael Sharpe and colleagues' study of cognitive behaviour therapy in the chronic fatigue syndrome.1 The authors managed to obtain almost 100% uptake of treatment and compliance among patients who were attending an infectious diseases clinic and were strongly convinced that their chronic fatigue had a physical cause. We would struggle to engage our patients similarly, even with two hours for an initial appointment, and we could not offer them anything approaching an hour of treatment a week for four months. The difference between what was provided in the study and what clinicians can routinely offer their patients makes it important to identify the essential elements of the treatment.

The package given included cognitive techniques such as "question[ing] a simple disease explanation," "strategies to reduce excessive perfectionism and self criticism," and a problem solving approach of "gradual and consistent increases in activity." The . . . [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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