Patients' beliefs about their illness were probably not a major factor

BMJ 1996;312:1097-1098 (27 April)

Letters

Patients' beliefs about their illness were probably not a major factor

EDITOR,--Michael Sharpe and colleagues' study confirms thatthe best medical advice for patients with the chronic fatiguesyndrome is not "nothing can be done" or that "the disease willburn itself out."¹ The study produced improvement in 73% ofthe patients, which is comparable to the 80% improvement producedby my management techniques.² ³ Interestingly, my approach seemsto be fundamentally different from that of Sharpe and colleagues.

Two previous studies of cognitive behaviour therapy in patientswith the chronic fatigue syndrome showed no benefit over ordinarymedical management.⁴ ⁵ What is meant by cognitive behaviourtherapy may go some way to explaining this apparent discrepancybetween previous studies and that of Sharpe and colleagues.Most of us would agree that "inaccurate and unhelpful beliefs,ineffective coping behaviour, negative mood states, social problems,and pathophysiological processes all interact to perpetuatethe illness."¹ I would also agree with Sharpe and colleagues'next statement . . . [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]