Essential elements of the treatment must be identified

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Stephen M Lawrie,
Anthony J Pelosi

Lecturer Department of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF
Consultant psychiatrist Hairmyres Hospital, Glasgow G75 8RG

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 …