A new study comparing treatments to fight chronic fatigue syndrome has found that cognitive behavioral therapy, which changes the way sufferers think about and respond to fatigue, can have a far more positive effect on the condition than previously thought.
Chronic fatigue syndrome affects around 2% of the world’s population and its main symptom is intense long term fatigue that doesn’t improve with rest or sleep, but is made worse by physical or mental activity. Because the exact cause of chronic fatigue syndrome is unknown it is difficult to treat, and most therapies focus on reducing the symptoms.
What Does the Study Show?
The study, which was published in The Lancet and undertaken by the University of Edinburgh and Queen Mary University of London, compared three possible treatments designed to fight chronic fatigue syndrome. These were:
- Adaptive pacing therapy, which simply involves changing your lifestyle so you do less, and therefore avoid fatigue. This is the most common form of treatment for chronic fatigue syndrome and until recently was considered the only safe treatment.
- Cognitive behavioral therapy, which uses psychological techniques to address fears of exercise and change patients’ response to fatigue.
- Graded exercise therapy, which slowly increases the level of exercise a patient does, following a plan that is specifically tailored to their individual condition.
Adaptive pacing therapy is the default treatment used to fight chronic fatigue syndrome, because most doctors don’t believe that cognitive behavioral therapy works for this condition, and because they believe graded exercise therapy could be dangerous; potentially making the condition worse.
In addition to adaptive pacing, many sufferers of chronic fatigue syndrome are prescribed painkillers, sleeping tablets, or anti depressants to combat the symptoms of the condition, which can actually impair their overall physical and mental abilities.
A group of 641 British volunteers took part in the study. They all had chronic fatigue syndrome but none were bedridden with the condition. They were divided into four groups that were given the following treatments over a six month period:
- Just medical care
- Medical care and adaptive pacing therapy
- Medical care and cognitive behavioral therapy
- Medical care and graded exercise therapy
The volunteers in the study were monitored for one year after their treatment ceased to assess the long term impact of the treatments.
The study concluded that the most effective therapy for chronic fatigue syndrome was cognitive behavioural therapy. Patients in this group were able to increase their physical activity and control their symptoms more effectively due to the alteration in their perception of tiredness.
30% of patients in the cognitive behavioral therapy group achieved and retained normal levels of physical activity and fatigue.
Graded exercise was also seen to be an effective therapy, and many patients in the group were able to gradually increase the intensity of physical exercise they were capable of without worsening the symptoms of chronic fatigue syndrome. The study determined that this therapy was safe as long as the exercise plans were carefully tailored to the individual.
The study found that adaptive pacing therapy, the main therapy currently used to treat chronic fatigue syndrome, had little or no benefit to the patients in that group. The researchers hope that the study will prompt doctors to explore the possibility of alternative therapies, rather than simply recommending adaptive pacing therapy by default.
The results of the study also support the idea that it may be possible to cure chronic fatigue syndrome and it isn’t just a condition that people have to accept and learn to live with. Hans Knoop, a clinical psychologist at the Expert Centre for Chronic Fatigue in Nijmegen, the Netherlands, stated that “I hope more people will be convinced you can treat chronic fatigue syndrome and that this isn’t necessarily something people will have forever.”