Deale, A, Chalder, T, Marks, I et al. · The American journal of psychiatry · 1997 · DOI
This study tested whether cognitive behavior therapy (CBT)—a type of talk therapy that helps change unhelpful thought patterns and gradually increase activity—works better than relaxation exercises for ME/CFS. Sixty patients received 13 sessions of either CBT or relaxation training. The CBT group showed significantly greater improvements in fatigue and ability to function, with 70% experiencing substantial improvement compared to only 19% in the relaxation group. These improvements lasted at least 6 months.
This landmark study provided robust evidence that a structured psychological intervention can meaningfully improve ME/CFS symptoms and functioning. For patients, it demonstrates that CBT is an evidence-based treatment option. For researchers, it established a methodological template for evaluating behavioral interventions and contributed to understanding the role of psychological factors in symptom management.
This study does not prove that ME/CFS is primarily psychological or caused by negative thoughts—it demonstrates that CBT can help manage symptoms regardless of underlying etiology. It also does not establish whether the benefits came from graded activity, cognitive changes, or other therapeutic mechanisms, nor does it address whether CBT works for all ME/CFS patients or only specific subgroups.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Contribute
Private, reviewed by a human. Not a public comment thread.