Background: Cognitive behavioural therapy (CBT) for chronic fatigue syndrome (CFS) leads to a decrease in symptoms and disabilities. There is controversy about the nature of the change following treatment; some suggest that patients improve by learning to adapt to a chronic condition, others think that recovery is possible. The objective of this study was to find out whether recovery from CFS is possible after CBT. Methods: The outcome of a cohort of 96 patients treated for CFS with CBT was studied. The definition of recovery was based on the absence of the criteria for CFS set up by the Center for Disease Control (CDC), but also took into account the perception of the patients’ fatigue and their own health. Data from healthy population norms were used in calculating conservative thresholds for recovery. Results: After treatment, 69% of the patients no longer met the CDC criteria for CFS. The percentage of recovered patients depended on the criteria used for recovery. Using the most comprehensive definition of recovery, 23% of the patients fully recovered. Fewer patients with a co-morbid medical condition recovered. Conclusion: Significant improvement following CBT is probable and a full recovery is possible. Sharing this information with patients can raise the expectations of the treatment, which may enhance outcomes without raising false hopes.

Whiting P, Bagnall AM, Sowden AJ, Cornell JE, Mulrow CD, Ramirez G: Interventions for the treatment and management of chronic fatigue syndrome: a systematic review. J Am Med Assoc 2001;286:1360–1368.
Stulemeijer M, de Jong LWAM, Fiselier TJW, Hoogveld SWB, Bleijenberg G: Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial. Br Med J 2005;330:7481–7486.
Prins JB, Bleijenberg G, de Boo TM, van der Meer JWM: Cognitive behaviour therapy for chronic fatigue syndrome: correspondence, authors reply. Lancet 2001;358:240–241.
Fava GA: The concept of recovery in affective disorders. Psychother Psychosom 1996;65:2–13.
Andrews G: Should depression be managed as a chronic disease? Br Med J 2001;322:419–421.
Cho HJ, Hotopf M, Wessely S: The placebo response in the treatment of chronic fatigue syndrome: a systematic review and meta-analysis. Psychosom Med 2005;67:301–313.
Di Blasi Z, Harkness E, Ernst E, Georgiou A, Kleijne J: Influence of context effects on health outcomes: a systematic review. Lancet 2001;357:757–762.
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A: The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med1994;121:953–959.
Vercoulen JHMM, Swanink CMA, Fennis JFM, Galama, JMD, van der Meer JWM, Bleijenberg G: Dimensional assessment of chronic fatigue syndrome. JPsychosom Res 1994;38:383–392.
Van der Werf SP, De Vree B, van der Meer JWM, Bleijenberg G: Natural course and predicting self-reported improvement in patients with a relatively short illness duration. J Psychosom Res 2003;53:749–753.
Bleijenberg G, Prins J, Bazelmans E: Cognitive behavioral therapies; in Jason LA, Fennell PA, Taylor RR (eds):Handbook of Chronic Fatigue Syndrome. New York, Wiley & Sons, 2003, pp 493–526.
Prins JB, Bleijenberg G, Bazelmans E, Elving L, de Boo TM, Severens JL, van der Wilt GJ, Spinhoven P, van der Meer JWM: Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial. Lancet 2001;357:841–847.
Vercoulen JHMM, Alberts M, Bleijenberg G: De Checklist Individual Strength (CIS) (The Checklist Individual Strength). Gedragstherapie (Behavioural Therapy) 1999;32:642–649.
Stewart A, Hays R, Ware J: The MOS short form general health survey: reliability and validity in a patient population. Med Care 1988;26:724–732.
Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–483.
Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, Sprangers MA, te Velde A, Verrips E: Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease population. J Clin Epidemiol 1998;51:1055–1068.
Servaes P, Verhagen C, Bleijenberg G: Determinants of chronic fatigue in disease-free breast cancer patients, a cross-sectional study. Ann Oncol 2002;13:589–598.
Pasquali R: The biological balance between psychological well-being and distress: a clinician’s point of view. Psychother Psychosom 2006;75:69–71.
Ryff CD, Dienberg Love G, Urry HL, Muller D, Rosenkranz MA, Friedman EM, Davidson RJ, Singer B: Psychological well-being and ill-being: do they have distinct or mirrored biological correlates? Psychother Psychosom 2006;75:85–95.
Cairns R, Hotoph M: A systematic review describing the prognosis of chronic fatigue syndrome. Occup Med C 2005;55:20–31.
Deale A, Husain K, Chalder T, Wessely S: Long-term outcome of cognitive behaviour therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study. Am J Psychiatry 2001;158:2038–2042.
White PD, Thomas JM, Amess J, Grover SA, Kangro HO, Clare AW: The existence of a fatigue syndrome after glandular fever. Psychol Med 1995;25:907–916.
van Houdenhove B, Egle UT: Fibromyalgia: a stress disorder? Psychother Psychosom 2004;73:267–275.
Prins JB, Bos E, Huibers MJ, Servaes P, van der Werf SP, van der Meer JW, Bleijenberg G: Social support and the persistence of complaints in chronic fatigue syndrome. Psychother Psychosom 2004;73:174–182.
Bentall RP, Powell P, Nye FJ, Edwards RH: Predictors of response to treatment for chronic fatigue syndrome. Br J Psychiatry 2002;181:248–252.
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