Marlin, R G, Anchel, H, Gibson, J C et al. · The American journal of medicine · 1998 · DOI
This study tested whether a comprehensive treatment program combining medical care, psychiatric treatment, and cognitive-behavioral therapy (talk therapy focusing on thoughts and behaviors) could help people with ME/CFS. Fifty-one patients received this treatment, which included supervised exercise, sleep strategies, activity planning, and therapy. The results showed that about 61% returned to work or functioned at a work-like level, while 33 months later, those who completed treatment maintained their improvements, whereas untreated patients rarely improved.
This study provides evidence that a coordinated, multifaceted approach to ME/CFS involving medical, psychiatric, and behavioral interventions may produce clinically meaningful employment and functional outcomes. The long-term follow-up and comparison with untreated controls add strength to findings that have implications for rehabilitation and treatment planning in ME/CFS.
This study does not prove that cognitive-behavioral therapy alone causes improvement, as the intervention was multifaceted and patients self-selected for treatment, introducing selection bias. The small untreated control group and lack of randomization limit causal inference. The study does not establish whether improvements reflect disease remission, coping skill development, or other mechanisms.
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
Marlin, R G, Anchel, H, Gibson, J C, Goldberg, W M, & Swinton, M (1998). An evaluation of multidisciplinary intervention for chronic fatigue syndrome with long-term follow-up, and a comparison with untreated controls.. The American journal of medicine. https://doi.org/10.1016/s0002-9343(98)00174-0
BibTeX
@article{mecfsatlas-marlin-1998-evaluation-multidisciplinary,
author = {Marlin, R G and Anchel, H and Gibson, J C and Goldberg, W M and Swinton, M},
title = {An evaluation of multidisciplinary intervention for chronic fatigue syndrome with long-term follow-up, and a comparison with untreated controls.},
journal = {The American journal of medicine},
year = {1998},
doi = {10.1016/s0002-9343(98)00174-0},
note = {PubMed: 9790492},
url = {https://www.mecfsatlas.com/evidence/marlin-1998-evaluation-multidisciplinary},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/marlin-1998-evaluation-multidisciplinary
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