Multidisciplinary rehabilitation treatment versus cognitive behavioural therapy for patients with chronic fatigue syndrome: a randomized controlled trial

ObjectivesThe aim of this trial was to evaluate the difference in treatment effect, at 26 and 52weeks after the start of treatment, between cognitive behavioural therapy (CBT) and multidisciplinary rehabilitation treatment (MRT) for patients with chronic fatigue syndrome (CFS).

DesignMulticentre, randomized controlled trial of patients with CFS. Participants were randomly assigned to MRT or CBT.

SettingFour rehabilitation centres in the Netherlands.

SubjectsA total of 122 patients participated in the trial.

Main outcome measuresPrimary outcomes were fatigue measured by the fatigue subscale of the Checklist Individual Strength and health-related quality of life measured by the Short-Form 36. Outcomes were assessed prior to treatment and at 26 and 52weeks after treatment initiation.

ResultsA total of 114 participants completed the assessment at 26weeks, and 112 completed the assessment at 52weeks. MRT was significantly more effective than CBT in reducing fatigue at 52weeks. The estimated difference in fatigue between the two treatments was -3.02 [95% confidence interval (CI) -8.07 to 2.03; P=0.24] at 26weeks and -5.69 (95% CI -10.62 to -0.76; P=0.02) at 52weeks. Patients showed an improvement in quality of life over time, but between-group differences were not significant.

ConclusionThis study provides evidence that MRT is more effective in reducing long-term fatigue severity than CBT in patients with CFS. Although implementation in comparable populations can be recommended based on clinical effectiveness, it is advisable to analyse the cost-effectiveness and replicate these findings in another multicentre trial.