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

BMJ 2004; 330 doi: (Published 30 December 2004) Cite this as: BMJ 2004;330:14

This article has a correction. Please see:

  1. Maja Stulemeijer, junior researcher1,
  2. Lieke W A M de Jong, child psychologist2,
  3. Theo J W Fiselier, paediatrician3,
  4. Sigrid W B Hoogveld, junior researcher1,
  5. Gijs Bleijenberg, professor of psychology (G.Bleijenberg{at}
  1. 1Expert Centre Chronic Fatigue, University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Netherlands,
  2. 2Department of Medical Psychology, University Medical Centre Nijmegen,
  3. 3Department of Paediatrics, University Medical Centre Nijmegen
  1. Correspondence to: G Bleijenberg
  • Accepted 7 October 2004


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

Design Randomised controlled trial.

Setting Department of child psychology.

Participants 71 consecutively referred patients with chronic fatigue syndrome; 36 were randomly assigned to immediate cognitive behaviour therapy and 35 to the waiting list for therapy.

Intervention 10 sessions of therapy over five months. Treatment protocols depended on the type of activity pattern (relatively active or passive). All participants were assessed again after five months.

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

Results 62 patients had complete data at five months (29 in the immediate therapy group and 33 on the waiting list). Patients in the therapy group reported significantly greater decrease in fatigue severity (difference in decrease on checklist individual strength was 14.5, 95% confidence interval 7.4 to 21.6) and functional impairment (difference in increase on SF-36 physical functioning was 17.3, 6.2 to 28.4) and their attendance at school increased significantly (difference in increase in percentage school attendance was 18.2, 0.8 to 35.5). They also reported a significant reduction in several accompanying symptoms. Self reported improvement was largest in the therapy group.

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


  • Contributors MS undertook the allocation procedure, coordinated data collection from March 2002, performed all analyses, and wrote the paper. LWAMdJ contributed to the design of the study, treated some of the participants, screened all patients, and contributed to the writing. TJWF was responsible for diagnoses and referral to department of child psychology and contributed to editing the paper. SWBH contributed to the design of the study, undertook the allocation procedure, and coordinated data collection until March 2002. GB developed the original idea, was responsible for study coordination, training, and supervision of therapists, and contributed to editing of the paper. GB is the guarantor.

  • Funding Foundation for Children's Welfare Stamps Netherlands (Stichting Kinderpostzegels Nederland) and the ME Society (ME Stichting).

  • Competing interest None declared.

  • Ethical approval Human Ethics Committee of the University Medical Centre Nijmegen.

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