Nijhof, Sanne L, Priesterbach, Loudy P, Uiterwaal, Cuno S P M et al. · Pediatrics · 2013 · DOI
This study followed adolescents with ME/CFS for nearly 3 years after they completed an internet-based cognitive behavioral therapy program called FITNET. About 59% of teenagers had recovered from their illness by the end of the follow-up period, and most of those who improved right after treatment stayed better. Interestingly, teens who received standard care also recovered at similar rates over time, though it took longer.
This study provides important evidence that internet-based CBT can produce lasting improvements in adolescent ME/CFS, offering an accessible alternative to face-to-face treatment when availability is limited. The finding that usual care eventually achieves similar recovery rates, albeit more slowly, adds nuance to treatment planning and suggests that time and other factors beyond structured intervention may facilitate recovery in some adolescents.
This study does not prove that FITNET is superior to usual care for long-term recovery, since both groups showed similar recovery rates at follow-up. It also does not establish causation for the predictors identified (disease duration, maternal focus on symptoms)—these may be markers of other underlying factors affecting recovery. The lack of a pure no-treatment control limits conclusions about the natural history of adolescent ME/CFS.
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
Nijhof, Sanne L, Priesterbach, Loudy P, Uiterwaal, Cuno S P M, Bleijenberg, Gijs, Kimpen, Jan L L, & van de Putte, Elise M (2013). Internet-based therapy for adolescents with chronic fatigue syndrome: long-term follow-up.. Pediatrics. https://doi.org/10.1542/peds.2012-2007
BibTeX
@article{mecfsatlas-nijhof-2013-internet-based,
author = {Nijhof, Sanne L and Priesterbach, Loudy P and Uiterwaal, Cuno S P M and Bleijenberg, Gijs and Kimpen, Jan L L and van de Putte, Elise M},
title = {Internet-based therapy for adolescents with chronic fatigue syndrome: long-term follow-up.},
journal = {Pediatrics},
year = {2013},
doi = {10.1542/peds.2012-2007},
note = {PubMed: 23669515},
url = {https://www.mecfsatlas.com/evidence/nijhof-2013-internet-based},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/nijhof-2013-internet-based
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