Quote Originally Posted by Gerwyn View Post

Although Cognitive Behavior Therapy (CBT) is widely recommended for patients with ME/CFS, it is far from clear whether cognitive behavior therapy is helpful for most patients.

The rationale for using CBT in ME/CFS is that inaccurate beliefs (that etiology is physical) and ineffective coping (activity avoidance) maintain and perpetuate CFS morbidity (Deale et al, 1997;Sharpe et al, 1996).

However, it has never been proven that these illness beliefs contribute to morbidity in CFS.

Where correlations do exist it is possible, even likely, that beliefs in physical etiology are correct and that activity avoidance is necessary for the more severely ill (Lloyd et al, 1993;Ray et al, 1995).

Of the 6 reported studies using CBT in “ME/CFS” two selected patients as defined by the Oxford (Deale et al, 1997;Sharpe et al, 1996) one using the Australian criteria (Lloyd et al, 1993) and one using the Fukuda criteria “with the exception of the criterion requiring four of eight additional symptoms to be present” (Prins et al, 2001).

These methods of patient selection allow for considerable heterogeneity and inclusion of psychiatrically ill patients with fatigue.

Therefore, the results may not be applicable to the
average Fukuda or Canadian defined patient.

Of the remaining two studies using valid selection criteria, one found no benefit of CBT (Friedberg & Krupp, 1994).

The only study reporting benefit (improved functional capacity and decreased fatigue) was conducted in adolescents (Stulemeijer et al, 2005).

It is important to note that no CBT study has reported that patients have been improved enough to return to work nor have they reported changes in the physical symptoms of CFS eg. muscle pain, fever, lymphadenopathy, headache or orthostatic intolerance.

Furthermore, clinical experience suggests that trying to convince a patient with ME/CFS that s/he does not have a physical disorder and should not rest when tired leads to conflict in the doctor-patient relationship and poor outcome for the patients. Therefore it would be prudent to await further research before recommending this CBT approach. Psychiatric Treatment Guidelines—E. Stein, ©2005

This seems to me to be both correct, minimalistic, and more or less the lingo our kind of psychos - Gerwyn & I, I mean: -logists - use when talking to their kind.

Except I would simply excise

Therefore, the results may not be applicable to the
average Fukuda or Canadian defined patient.

It is both debatable with "may" replaced by "are" and pretty void with it.