Evidence based care for people with chronic fatigue syndrome and myalgic encephalomyelitis

Michael Sharpe, Trudie Chalder, Peter White

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Chronic fatigue syndrome (CFS), sometimes referred to as myalgic encephalomyelitis (ME) and often as CFS/ME, is an illness characterized by disabling fatigue and other symptoms, typically worsened by activity. The main evidence-based treatments are rehabilitative in nature and include specific types of cognitive behavior therapy (CBT), and graded exercise therapy (GET). In this article we briefly review the evidence for their safety and effectiveness and propose that much of the controversy about them arises from misunderstandings about their nature and delivery. In particular, we emphasize that successful rehabilitation from CFS/ME does not indicate that the illness is not real. We recommend that rehabilitative treatment always be preceded by a thorough clinical assessment and delivered by appropriately trained therapists working in close collaboration with the patient. We conclude that properly applied rehabilitative treatments offer the best hope of safely improving fatigue and function for patients with CFS/ME. However, we also recognize the need for more research into the treatment of this neglected condition, especially for those most severely disabled by it.
Original languageEnglish
JournalJournal of General Internal Medicine
Publication statusAccepted/In press - 1 Oct 2021


  • chronic fatigue syndrome
  • myalgic encephalomyelitis
  • management
  • cognitive behavior therapy
  • graded exercise therapy


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