Deale, A, Husain, K, Chalder, T et al. · The American journal of psychiatry · 2001 · DOI
Researchers compared two types of therapy for ME/CFS: cognitive behavior therapy (CBT, which focuses on changing thought patterns and gradually increasing activity) and relaxation therapy. After 5 years, 68% of people who received CBT reported feeling much or very much improved, compared to 36% who received relaxation therapy. However, neither therapy fully eliminated fatigue symptoms, and some patients found it hard to keep improving after their regular treatment ended.
This study provides long-term evidence that CBT may produce sustained functional benefits in ME/CFS beyond the treatment period, offering both patients and clinicians insight into realistic expectations and durability of gains. It highlights that while behavioral interventions can help, they do not typically normalize fatigue or eliminate the need for ongoing symptom management.
This study does not prove CBT cures ME/CFS or restores normal fatigue levels. It also does not establish whether CBT's mechanisms of benefit are biological or primarily psychological, nor does it address whether the improvements reflect true physiological recovery or changes in coping and perception. The lack of a true untreated control group limits causal inference about natural history versus treatment effects.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Deale, A, Husain, K, Chalder, T, & Wessely, S (2001). Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study.. The American journal of psychiatry. https://doi.org/10.1176/appi.ajp.158.12.2038
BibTeX
@article{mecfsatlas-deale-2001-long-term,
author = {Deale, A and Husain, K and Chalder, T and Wessely, S},
title = {Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study.},
journal = {The American journal of psychiatry},
year = {2001},
doi = {10.1176/appi.ajp.158.12.2038},
note = {PubMed: 11729022},
url = {https://www.mecfsatlas.com/evidence/deale-2001-long-term},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/deale-2001-long-term
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