Malik, Sadaf, Asprusten, Tarjei Tørre, Pedersen, Maria et al. · BMJ paediatrics open · 2020 · DOI
This study tested whether combining two types of therapy—cognitive-behavioral therapy (which helps change thought patterns and behaviors) and music therapy—could help adolescents recover from prolonged fatigue that started after an Epstein-Barr virus infection. Over 15 months, researchers compared 21 young people who received the combined therapy with 22 who received standard care. The therapy was safe and well-tolerated, and there were hints that it might help with symptom recovery, though the study was too small to prove effectiveness.
ME/CFS and postinfectious fatigue remain poorly treated, and evidence-based psychological interventions remain controversial in this population. This feasibility study is the first to examine whether combined CBT and music therapy is tolerable and potentially beneficial specifically in postinfectious fatigue, rather than in heterogeneous ME/CFS populations. If confirmed in a larger trial, such a combined approach might offer a safe, multimodal option for adolescents with debilitating postinfectious fatigue.
This study does not prove that CBT plus music therapy is effective for postinfectious fatigue; it was explicitly underpowered for efficacy, and the observed differences in activity and symptom scores were not statistically significant. The high early dropout rate (7/43 by 3 months) raises questions about long-term acceptability and adherence. The study also cannot determine which component (CBT or music therapy) drove any observed benefit, nor whether benefits persist beyond 15 months.
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
Malik, Sadaf, Asprusten, Tarjei Tørre, Pedersen, Maria, Mangersnes, Julie, Trondalen, Gro, van Roy, Betty, et al. (2020). Cognitive-behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study.. BMJ paediatrics open. https://doi.org/10.1136/bmjpo-2019-000620
BibTeX
@article{mecfsatlas-malik-2020-cognitive-behavioural,
author = {Malik, Sadaf and Asprusten, Tarjei Tørre and Pedersen, Maria and Mangersnes, Julie and Trondalen, Gro and van Roy, Betty and Skovlund, Eva and Wyller, Vegard Bruun},
title = {Cognitive-behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study.},
journal = {BMJ paediatrics open},
year = {2020},
doi = {10.1136/bmjpo-2019-000620},
note = {PubMed: 32342016},
url = {https://www.mecfsatlas.com/evidence/malik-2020-cognitive-behavioural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/malik-2020-cognitive-behavioural
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