Janse, Anthonie, Nikolaus, Stephanie, Wiborg, Jan F et al. · Journal of psychosomatic research · 2017 · DOI
This study followed 511 people for up to 10 years after they completed cognitive behaviour therapy (CBT) for ME/CFS. While about 70% of people maintained improved physical function, fatigue levels increased somewhat over time, and some people experienced a return of severe fatigue and activity limitations. The results suggest CBT can help many people in the long term, but not everyone stays better.
Long-term follow-up data are rare in ME/CFS research and critical for understanding whether therapy benefits persist. This study addresses whether CBT improvements are durable or temporary, which directly affects how patients and clinicians should view CBT as a long-term management strategy. Understanding who maintains improvement and who relapses can inform better treatment planning and relapse prevention strategies.
This study does not prove that CBT causes the observed improvement or deterioration—it documents outcomes without a control group for comparison at follow-up. It also does not establish whether increased fatigue at follow-up reflects true relapse, natural disease fluctuation, or accumulating life stressors. The study cannot explain why some people maintained gains while others deteriorated.
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
Janse, Anthonie, Nikolaus, Stephanie, Wiborg, Jan F, Heins, Marianne, van der Meer, Jos W M, Bleijenberg, Gijs, et al. (2017). Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome.. Journal of psychosomatic research. https://doi.org/10.1016/j.jpsychores.2017.03.016
BibTeX
@article{mecfsatlas-janse-2017-long-term,
author = {Janse, Anthonie and Nikolaus, Stephanie and Wiborg, Jan F and Heins, Marianne and van der Meer, Jos W M and Bleijenberg, Gijs and Tummers, Marcia and Twisk, Jos and Knoop, Hans},
title = {Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome.},
journal = {Journal of psychosomatic research},
year = {2017},
doi = {10.1016/j.jpsychores.2017.03.016},
note = {PubMed: 28606498},
url = {https://www.mecfsatlas.com/evidence/janse-2017-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/janse-2017-long-term
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