Kolala, Vivek, La Rosa, Billie, Vangaveti, Venkat et al. · Frontiers in psychiatry · 2025 · DOI
This review looked at 12 studies involving nearly 1,800 people with ME/CFS to see if cognitive behavioural therapy (CBT)—a type of talking therapy that focuses on thoughts and behaviours—helps reduce fatigue and improve daily functioning. The results were mixed: one-on-one CBT showed promise for reducing fatigue, and self-directed CBT (doing it yourself with materials) helped some people function better physically. However, group CBT and other forms didn't show clear benefits. No serious harms were reported, but the quality of evidence was limited by inconsistent reporting across studies.
This systematic review synthesizes current evidence on a commonly recommended treatment for ME/CFS, helping patients and clinicians make informed decisions about whether CBT might be appropriate. The differentiation between CBT modalities (individual, self-directed, group) provides practical guidance on which approaches may be most beneficial for different patient presentations. The findings contribute to ongoing debate about ME/CFS treatment guidelines and highlight the need for higher-quality, better-reported studies.
This meta-analysis does not prove that CBT cures or substantially treats ME/CFS as a whole—the authors explicitly note it should be considered only as a supportive, non-curative option. The mixed results and high heterogeneity mean we cannot definitively establish which patients will benefit most or why some forms work better than others. The inconsistent reporting of adverse effects means we cannot fully characterize potential harms, and the inability to blind participants inherently introduces bias that may inflate 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
Kolala, Vivek, La Rosa, Billie, Vangaveti, Venkat, & Chen, Kai Yang (2025). Cognitive behavioural therapy for the treatment of chronic fatigue syndrome in adults - a meta-analysis.. Frontiers in psychiatry. https://doi.org/10.3389/fpsyt.2025.1647897
BibTeX
@article{mecfsatlas-kolala-2025-cognitive-behavioural,
author = {Kolala, Vivek and La Rosa, Billie and Vangaveti, Venkat and Chen, Kai Yang},
title = {Cognitive behavioural therapy for the treatment of chronic fatigue syndrome in adults - a meta-analysis.},
journal = {Frontiers in psychiatry},
year = {2025},
doi = {10.3389/fpsyt.2025.1647897},
note = {PubMed: 41244870},
url = {https://www.mecfsatlas.com/evidence/kolala-2025-cognitive-behavioural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/kolala-2025-cognitive-behavioural
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