Sharpe, M · The American journal of medicine · 1998 · DOI
This review examines cognitive behavior therapy (CBT), a talk-based treatment that helps people change thought patterns and behaviors that may be making their fatigue worse. Research from two rigorous clinical trials shows that CBT can significantly help people with ME/CFS feel better and become more active. While most people improve, complete recovery is rare.
This review consolidates evidence that CBT produces meaningful symptom improvement in ME/CFS patients, offering an accessible non-pharmacologic treatment option. It highlights both the potential benefits and realistic limitations of this approach, informing patient expectations and clinical practice standards. The discussion of implementing CBT in routine settings addresses a critical gap in treatment availability for this underserved patient population.
This review does not establish that cognitive or behavioral factors are the primary cause of ME/CFS, only that addressing certain patterns can help manage symptoms. The study cannot prove CBT works equally well for all patients or determine which patients benefit most. It also does not establish that CBT addresses underlying biological mechanisms of the disease.
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
Sharpe, M (1998). Cognitive behavior therapy for chronic fatigue syndrome: efficacy and implications.. The American journal of medicine. https://doi.org/10.1016/s0002-9343(98)00170-3
BibTeX
@article{mecfsatlas-sharpe-1998-cognitive-behavior-2,
author = {Sharpe, M},
title = {Cognitive behavior therapy for chronic fatigue syndrome: efficacy and implications.},
journal = {The American journal of medicine},
year = {1998},
doi = {10.1016/s0002-9343(98)00170-3},
note = {PubMed: 9790491},
url = {https://www.mecfsatlas.com/evidence/sharpe-1998-cognitive-behavior-2},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/sharpe-1998-cognitive-behavior-2
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