The controversies surrounding the effectiveness of cognitive behavioural therapy and graded exercise therapy for chronic fatigue syndrome are explained using Cohen’s d effect sizes rather than arbitrary thresholds for ‘success’. This article shows that the treatment effects vanish when switching to objective outcomes. The preference for subjective outcomes by the PACE trial team leads to false hope. This article provides a more realistic view, which will help patients and their doctors to evaluate the pros and cons.
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Van EssenMde WinterLJM (2002) Cognitieve gedragstherapie bij het chronisch vermoeidheidssyndroom. Amstelveen: College voor Zorgverzekeringen, report 02/111, appendix 1, p. 10.
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WhitePDChalderTSharpeM. (2017) Response to the editorial by Dr Geraghty. Journal of Health Psychology22(9): 1113–1117.
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WhitePDGoldsmithKAJohnsonAL. (2011) Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): A randomised trial. The Lancet377(9768): 823–836.
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WhitePDSharpeMCChalderT. (2007) Protocol for the PACE trial: A randomised controlled trial of adaptive pacing, cognitive behaviour therapy, and graded exercise as supplements to standardised specialist medical care versus standardised specialist medical care alone for patients with the chronic fatigue syndrome/myalgic encephalomyelitis or encephalopathy. BMC Neurology7: 6.
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WiborgJFKnoopHStulemijerM. (2010) How does cognitive behaviour therapy reduce fatigue in patients with chronic fatigue syndrome? The role of physical activity. Psychological Medicine40(8): 1281–1287.
