Van Houdenhove, Boudewijn, Luyten, Patrick · Psychosomatics · 2008 · DOI
This review examined how ME/CFS and fibromyalgia affect people differently, and why treatments that work for some patients may not work for others. The authors found that while cognitive-behavioral therapy and graded exercise are evidence-based treatments, their success depends on identifying what specific factors are keeping each patient stuck—such as stress, sleep problems, or how they think about their illness. The key message is that personalized treatment plans tailored to each patient's individual perpetuating factors are likely to be more effective than one-size-fits-all approaches.
This study is important because it highlights why ME/CFS and fibromyalgia patients respond differently to the same treatments—a critical issue for improving clinical outcomes. By emphasizing the role of individual perpetuating factors, it supports the need for personalized medicine approaches and challenges the assumption that standard treatments work equally well for all patients. Understanding these differences can help clinicians design better, more acceptable treatment plans.
This review does not provide new empirical data proving which specific perpetuating factors respond best to which treatments, nor does it establish causal mechanisms linking perpetuating factors to treatment outcomes. It also does not definitively prove that customized approaches outperform standardized ones—this remains a hypothesis requiring rigorous clinical trials. The study cannot establish what neurobiological recovery mechanisms underlie successful treatment in either condition.
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
Van Houdenhove, Boudewijn & Luyten, Patrick (2008). Customizing treatment of chronic fatigue syndrome and fibromyalgia: the role of perpetuating factors.. Psychosomatics. https://doi.org/10.1176/appi.psy.49.6.470
BibTeX
@article{mecfsatlas-van-houdenhove-2008-customizing-treatment,
author = {Van Houdenhove, Boudewijn and Luyten, Patrick},
title = {Customizing treatment of chronic fatigue syndrome and fibromyalgia: the role of perpetuating factors.},
journal = {Psychosomatics},
year = {2008},
doi = {10.1176/appi.psy.49.6.470},
note = {PubMed: 19122123},
url = {https://www.mecfsatlas.com/evidence/van-houdenhove-2008-customizing-treatment},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/van-houdenhove-2008-customizing-treatment
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