Different Therapies Improve Chronic Fatigue Outcomes

Cognitive behavior and graded exercise therapy effective additions to specialist medical care

FRIDAY, Feb. 18 (HealthDay News) -- For chronic fatigue patients, cognitive behavior therapy (CBT) and graded exercise therapy (GET) may moderately improve outcomes when added to specialist medical care (SMC), according to research published online Feb. 18 in The Lancet.

Peter D. White, M.D., of the Queen Mary University of London, and colleagues randomly assigned 641 patients with chronic fatigue syndrome to receive SMC with CBT, GET, or adaptive pacing therapy (APT), or to receive SMC alone, to assess safety and efficacy for each therapeutic approach. The primary outcomes were fatigue and physical function up to one year after randomization.

Compared with the SMC-alone group, mean fatigue scores at one year were lower and mean function scores higher for the CBT and GET groups. However, the fatigue and physical function scores for the APT group did not differ from those of the SMC-alone group. The researchers recorded serious adverse reactions in 1 percent of the APT group, 2 percent of the CBT group, 1 percent of the GET group, and 1 percent of the SMC-alone group.

"In the pacing, graded activity, and cognitive behavior therapy: a randomized evaluation (PACE) trial, we affirm that cognitive behavior therapy and graded exercise therapy are moderately effective outpatient treatments for chronic fatigue syndrome when added to specialist medical care, as compared with adaptive pacing therapy or specialist medical care alone," the authors write.

Several authors disclosed financial relationships with publishing companies and/or insurance companies.

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