Sharpe, Michael, Goldsmith, Kimberley A, Johnson, Anthony L et al. · The lancet. Psychiatry · 2015 · DOI
This study followed up with people who participated in the PACE trial 2-3 years after it ended to see how they were doing long-term. People who received cognitive behavioral therapy (CBT) or graded exercise therapy (GET) maintained their improvements in fatigue and physical function. Interestingly, people who initially received standard medical care or adaptive pacing therapy also improved over time, though many had sought additional treatment on their own after the trial ended.
Long-term follow-up data are critical for understanding whether ME/CFS treatments produce sustained benefit or represent temporary improvement. This study provides rare multi-year outcome data, which informs patient expectations and treatment planning, though the high rate of additional treatment-seeking complicates interpretation of which interventions are most beneficial.
This study does not prove that CBT or GET are definitively superior long-term, because 44% of participants received additional treatments after the trial that were not controlled for in the long-term analysis. The improvement in SMC-alone and APT groups after 1 year may reflect regression to the mean, natural recovery, or the additional therapies received rather than the original intervention. The study also cannot establish causation for what drove improvement in any group.
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, Michael, Goldsmith, Kimberley A, Johnson, Anthony L, Chalder, Trudie, Walker, Jane, & White, Peter D (2015). Rehabilitative treatments for chronic fatigue syndrome: long-term follow-up from the PACE trial.. The lancet. Psychiatry. https://doi.org/10.1016/S2215-0366(15)00317-X
BibTeX
@article{mecfsatlas-sharpe-2015-rehabilitative-treatments,
author = {Sharpe, Michael and Goldsmith, Kimberley A and Johnson, Anthony L and Chalder, Trudie and Walker, Jane and White, Peter D},
title = {Rehabilitative treatments for chronic fatigue syndrome: long-term follow-up from the PACE trial.},
journal = {The lancet. Psychiatry},
year = {2015},
doi = {10.1016/S2215-0366(15)00317-X},
note = {PubMed: 26521770},
url = {https://www.mecfsatlas.com/evidence/sharpe-2015-rehabilitative-treatments},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/sharpe-2015-rehabilitative-treatments
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