White, Peter D, Chalder, Trudie, Sharpe, Michael · BJPsych bulletin · 2015 · DOI
The PACE trial tested whether adding specific therapies to standard medical care could help people with ME/CFS feel less tired and more able to do daily activities. The study compared four groups of patients: one receiving standard care alone, and three others receiving standard care plus either cognitive-behavioural therapy (talking therapy focused on thoughts and behaviours), graded exercise therapy (gradually increasing physical activity), or adaptive pacing therapy (learning to manage energy use). The researchers found that cognitive-behavioural and graded exercise therapies appeared to work better than the other treatments for reducing fatigue and improving physical function.
This study is one of the largest and most detailed trials examining psychological and rehabilitative therapies for ME/CFS, providing evidence that influenced clinical guidelines and treatment recommendations. Understanding what therapies have been tested and how they performed helps patients and clinicians make informed decisions about available treatment options.
This study does not prove that fatigue in ME/CFS is primarily psychological in origin, nor does it establish the biological mechanisms underlying any observed improvements. The findings reflect changes in self-reported outcomes and measured disability, which may not reflect underlying pathophysiology, and generalizability may be limited to patients meeting the trial's specific inclusion criteria.
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 →
Contribute
Private, reviewed by a human. Not a public comment thread.