Rometsch, Caroline, Martin, Alexandra, Cosci, Fiammetta · Clinical psychology & psychotherapy · 2025 · DOI
This review looked at 24 studies involving over 3,300 people to understand which factors help predict whether talk therapy will work well for conditions like ME/CFS, fibromyalgia, and IBS. Researchers found that how severe your symptoms are, whether you have depression or anxiety alongside your main condition, and the intensity of pain you experience can all affect how much therapy helps. This information could help doctors choose the right type of therapy for each person.
For ME/CFS patients, this review provides evidence-based guidance on which factors predict psychotherapy success, helping clinicians personalize treatment plans and manage expectations. Understanding that depression and anxiety comorbidity affects outcomes is particularly relevant, as these conditions frequently co-occur with ME/CFS. This systematic evidence could improve treatment matching and outcomes in this challenging population.
This review does not establish causation—only that certain factors are associated with better or worse outcomes. It does not prove that psychotherapy is equally effective for all ME/CFS patients, nor does it determine whether baseline severity actually limits improvement or simply reflects disease heterogeneity. The findings are primarily from CBT studies, so generalizability to other therapeutic approaches remains unclear.
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 →
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Primary citation
Rometsch, Caroline, Martin, Alexandra, & Cosci, Fiammetta (2025). Predictors of Treatment Success of Psychotherapy in Functional Disorders: A Systematic Review of the Literature.. Clinical psychology & psychotherapy. https://doi.org/10.1002/cpp.70075
BibTeX
@article{mecfsatlas-rometsch-2025-predictors-treatment,
author = {Rometsch, Caroline and Martin, Alexandra and Cosci, Fiammetta},
title = {Predictors of Treatment Success of Psychotherapy in Functional Disorders: A Systematic Review of the Literature.},
journal = {Clinical psychology & psychotherapy},
year = {2025},
doi = {10.1002/cpp.70075},
note = {PubMed: 40268525},
url = {https://www.mecfsatlas.com/evidence/rometsch-2025-predictors-treatment},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/rometsch-2025-predictors-treatment
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