Cognitive behavioral therapy (CBT) and graded exercise therapy (GET) are the most effective way to treat patients with Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME), according to a large randomized trial funded by the Medical Research Council and the UK government.
However, at least one charity group representing people with ME is not happy with the findings, and says they overstate the benefits of the two therapies.
In a statement, the MRC said the findings suggest cognitive behavioral therapy (CBT) and graded exercise therapy (GET) should be offered to all patients "who are able to attend hospital if they are suffering from fatigue caused by CFS/ME". They also said the findings support current guidelines from the National Institute for Health and Clinical Excellence (NICE).
Researchers from Queen Mary, University London, King's College London, and the University of Edinburgh, led the study, which was published online in The Lancet on 18 February.
No-one knows what causes CFS/ME, a debilitating condition that causes people to feel fatigue, have poor concentration and memory, and a range of other symptoms, including disturbed sleep, and pains in muscles and joints. The condition is complex and long-term and affects about quarter of a million people in the UK.
First author Professor Peter White, from Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, told the press that they found CBT and GET can safely help a significant number of patients:
"While there is still room for improvement, this is a real step forward in informing patients with CFS/ME which treatments can help to improve their health and ability to lead a more normal life," said White.
Co-author Professor Michael Sharpe, from the University of Edinburgh, said patients with CFS/ME can suffer for years, with debilitating symptoms that stop them leading a normal life.
He said previous trials had already suggested CBT and GET could help patients, but these were small and raised concerns about the safety of these treatments, while an alternative, the pacing method, was being widely put forward, but hadn't been tested.
"The PACE trial was designed to find out the relative benefits and harms of all of these treatments when combined with specialist medical care," said Sharpe.
PACE included 641 patients with CFS/ME who were able to attend hospitals and clinics in England and Scotland for treatment.
All patients met the "Oxford criteria" for CFS and were randomly allocated to one of four treatment groups. One group received only specialist medical care (160 patients), while the other three groups received specialist medical care plus one other therapy, either adaptive pacing therapy (APT, 160 patients), CBT (161 patients), or GET (160 patients), over six months.
