Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: A 5-year follow-up study

Objective: This study evaluated the longer outcome of cognitive behavior th erapy versus relaxation therapy for patients with chronic fatigue syndrome. Method: Sixty patients who participated in a randomized controlled trial of cognitive behavior therapy versus relaxation therapy for chronic fatigue s yndrome were invited to complete self-rated measures and participate in a 5 -year follow-up interview with an assessor who was blind to treatment type. Results: Fifty-three patients (88%) participated in the follow-up study: 25 received cognitive behavior therapy and 28 received relaxation therapy. A total of 68% of the patients who received cognitive behavior therapy and 36 % who received relaxation therapy rated themselves as "much improved" or "v ery much improved" at the 5-year follow-up. Significantly more patients rec eiving cognitive behavior therapy, in relation to those in relaxation thera py, met criteria for complete recovery, were free of relapse, and experienc ed symptoms that had steadily improved or were consistently mild or absent since treatment ended. Similar proportions were employed, but patients in t he cognitive behavior therapy group worked significantly more mean hours pe r week. Few patients crossed the threshold for "normal" fatigue, despite ac hieving a good outcome on other measures. Cognitive behavior therapy was po sitively evaluated and was still used by over 80% of the patients. Conclusions: Cognitive behavior therapy for chronic fatigue syndrome can pr oduce some lasting benefits but is not a cure. Once therapy ends, some pati ents have difficulty making further improvements. In the future, attention should be directed toward ensuring that gains are maintained and extended a fter regular treatment ends.