Takamatsu, Naoki, Kuga, Hironori · BMC infectious diseases · 2025 · DOI
This review examined whether cognitive behavior therapy (CBT)—a talking therapy that helps address thought patterns and behaviors—might help patients with long COVID who experience brain fog, fatigue, and mood problems. The authors compared long COVID to ME/CFS, noting they share many features, and found that while CBT may help some patients feel less tired and think more clearly, it works best when tailored to each person's energy limits and combined with other treatments. Importantly, the authors stress that suggesting CBT does not mean these illnesses are 'all in your head'—they have real physical causes.
For ME/CFS patients, this review is significant because it clarifies how psychological interventions like CBT should be carefully adapted for conditions with documented biological pathology, not applied as if the illness is primarily psychological. The comparison between long COVID and ME/CFS helps validate ME/CFS experiences and supports the growing recognition of shared mechanisms. This work provides evidence-based guidance for how any psychological support should be integrated thoughtfully into comprehensive, individualized care plans.
This review does not prove that CBT cures or reverses ME/CFS or long COVID, nor does it establish that these conditions are primarily psychiatric or psychological in origin. It does not demonstrate which specific CBT components work best or identify patient subgroups most likely to benefit. The review also does not prove causation between any proposed mechanisms (immune dysregulation, neuroinflammation) and symptom improvement from CBT.
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
Takamatsu, Naoki & Kuga, Hironori (2025). Applicability and adaptation of cognitive behavior therapy for long COVID neuropsychiatric symptoms: a review with insights from ME/CFS.. BMC infectious diseases. https://doi.org/10.1186/s12879-025-11754-0
BibTeX
@article{mecfsatlas-takamatsu-2025-applicability-adaptation,
author = {Takamatsu, Naoki and Kuga, Hironori},
title = {Applicability and adaptation of cognitive behavior therapy for long COVID neuropsychiatric symptoms: a review with insights from ME/CFS.},
journal = {BMC infectious diseases},
year = {2025},
doi = {10.1186/s12879-025-11754-0},
note = {PubMed: 41073921},
url = {https://www.mecfsatlas.com/evidence/takamatsu-2025-applicability-adaptation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/takamatsu-2025-applicability-adaptation
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