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October/November 2013 (vol. 10/3)

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Research Plus

Chronic fatigue recovery

The UK PACE trial was set up to compare treatments for chronic fatigue syndrome (CFS). Previous results have demonstrated that both cognitive behavioural therapy (CBT) and graded exercise therapy (GET) are more effective in reducing both fatigue and physical disability than adaptive pacing therapy (APT – a self-management technique designed to avoid over-exertion). This latest research shows that CBT and GET are both significantly more likely to lead to recovery than APT or specialist medical care (SMC). A total of 640 participants with CFS were randomised to either: SMC alone delivered by specialist CFS doctors; SMC plus APT delivered by occupational therapists; SMC plus CBT delivered by clinical psychologists; and SMC plus GET delivered by physiotherapists. Recovery at 52 weeks was 22% for both GET and CBT, 8% for APT and 7% for SMC. GET and CBT were significantly more likely to lead to recovery when compared to APT – odds ratio for CBT = 3.36 (95% CI 1.64–6.88); for GET = 3.38 (1.65–6.93). There was no significant difference between SMC alone and APT.

Psychological Medicine 2013; 43: 2227–2235

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Occupational Health at Work October/November 2013 (vol. 10/3) pp40