By David Tuller, DrPH
On November 10th, the National Institute of Health and Care Excellence published a draft of new clinical guidelines for ME/CFS. The draft represented a blunt rejection of the argument that the combination of “unhelpful cognitions” and deconditioning drive the illness. Under this once-hegemonic framework, indicated therapies include cognitive behavior therapy to overcome the unhelpful cognitions and graded exercise therapy to reverse the deconditioning. A review of the literature published along with the NICE draft assessed the quality of evidence from dozens of CBT and GET studies as “low” or “very low.”
On December 10th, the journal Clinical Child Psychology and Psychiatry published an article called “Paediatric chronic fatigue syndrome: 25 year perspective.” Two of the four authors—Professor Trudie Chalder of King’s College London and Professor Esther Crawley of Bristol University—have long been leaders in the field. In particular, the article highlights CBT as an effective intervention. It cites some of the research that NICE has assessed as yielding only “low” or “very low” quality evidence.
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