Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Authors: Peter D. White, Daniel J. Clauw, Jos W.M. van der Meer, Rona Moss-Morris, Renee R. Taylor
Journal: Annals of Internal Medicine (2015)

Letters1 December 2015Treatment of Myalgic Encephalomyelitis/Chronic Fatigue SyndromePeter D. White, MD, Daniel J. Clauw, MD, Jos W.M. van der Meer, MD, Rona Moss-Morris, PhD, and Renee R. Taylor, PhDPeter D. White, MDFrom Barts and The London School of Medicine, Queen Mary University, London, United Kingdom; University of Michigan, Ann Arbor, Michigan; Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Guy's Hospital, London, United Kingdom; University of Illinois, Chicago, Illinois.Search for more papers by this author, Daniel J. Clauw, MDFrom Barts and The London School of Medicine, Queen Mary University, London, United Kingdom; University of Michigan, Ann Arbor, Michigan; Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Guy's Hospital, London, United Kingdom; University of Illinois, Chicago, Illinois.Search for more papers by this author, Jos W.M. van der Meer, MDFrom Barts and The London School of Medicine, Queen Mary University, London, United Kingdom; University of Michigan, Ann Arbor, Michigan; Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Guy's Hospital, London, United Kingdom; University of Illinois, Chicago, Illinois.Search for more papers by this author, Rona Moss-Morris, PhDFrom Barts and The London School of Medicine, Queen Mary University, London, United Kingdom; University of Michigan, Ann Arbor, Michigan; Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Guy's Hospital, London, United Kingdom; University of Illinois, Chicago, Illinois.Search for more papers by this author, and Renee R. Taylor, PhDFrom Barts and The London School of Medicine, Queen Mary University, London, United Kingdom; University of Michigan, Ann Arbor, Michigan; Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Guy's Hospital, London, United Kingdom; University of Illinois, Chicago, Illinois.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5171 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Smith and colleagues (1) conclude that “trials of … counseling therapies and graded exercise therapy [GET] suggest benefit for some patients meeting case definitions for CFS, whereas evidence for … harms is insufficient.” Although we support the general conclusion of benefit with these treatments, we suggest that some aspects of this review may be misinterpreted. First, the most frequently tested behavioral intervention has been CBT, which aims to reduce symptoms and improve functioning. Considering this as “counseling,” which has different objectives and content, would be unusual. One would not combine different types of medicines in a review; ...References1. Smith ME, Haney E, McDonagh M, Pappas M, Daeges M, Wasson N, et al. Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162:841-50. [PMID: 26075755]. doi:10.7326/M15-0114 LinkGoogle Scholar2. Castell BD, Kazantzis N, Moss-Morris RE. Cognitive behavioral therapy and graded exercise for chronic fatigue syndrome: a meta-analysis. Clinical Psychology: Science and Practice. 2011;18:311-24. CrossrefGoogle Scholar3. Larun L, Brurberg KG, Odgaard-Jensen J, Price JR. Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2015;2:CD003200. [PMID: 25674924] MedlineGoogle Scholar4. Moss-Morris R, Sharon C, Tobin R, Baldi JC. A randomized controlled graded exercise trial for chronic fatigue syndrome: outcomes and mechanisms of change. J Health Psychol. 2005;10:245-59. [PMID: 15723894] CrossrefMedlineGoogle Scholar5. White PD, Goldsmith KA, Johnson AL, Potts L, Walwyn R, DeCesare JC, et al; PACE trial management group. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet. 2011;377:823-36. [PMID: 21334061] doi:10.1016/S0140-6736(11)60096-2 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Barts and The London School of Medicine, Queen Mary University, London, United Kingdom; University of Michigan, Ann Arbor, Michigan; Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands; Guy's Hospital, London, United Kingdom; University of Illinois, Chicago, Illinois.Note: The authors acknowledge Profs. Buchwald, Chalder, Knoop, Sharpe, and Wearden and Dr. Crawley. These CFS clinical scientists supported and approved this letter.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0449. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnostic Methods for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop Elizabeth Haney , M.E. Beth Smith , Marian McDonagh , Miranda Pappas , Monica Daeges , Ngoc Wasson , and Heidi D. Nelson Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Sean B.M. Kirby Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Alem Matthees Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Lily Chu , Lucinda Bateman , Todd Davenport , Eleanor Stein , and Staci Stevens Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Tom Kindlon and Charles Shepherd Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome M.E. Beth Smith , Elizabeth Haney , and Heidi D. Nelson Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Maik Speedy Metrics 1 December 2015Volume 163, Issue 11Page: 885KeywordsAdverse eventsCognitive behavior therapyDisclosureExerciseExercise therapyFatigueScientistsSerious adverse eventsSystematic reviews ePublished: 1 December 2015 Issue Published: 1 December 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...