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Proposed British Guidelines Reject Useless Chronic Fatigue Syndrome Treatments

Thursday 26 November 2020

 

From Stat:

 

Woman
 

Proposed British guidelines reject useless chronic fatigue syndrome treatments

By David Tuller and Steven Lubet
November 17, 2020
© 2020 Stat.

For years, the prevailing “wisdom” about people diagnosed with chronic fatigue syndrome was they were just terribly out of shape and harbored irrational fears they had an organic illness. The favored treatments were graded exercise therapy, designed to counter the deconditioning with a program of progressively increasing activity, a form of cognitive behavior therapy specifically designed to address the unfounded illness beliefs, or a combination of the two.

In the U.S., this psychological and behavioral theory of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), as the illness is now often called, has steadily lost ground in favor of a biomedical one. In 2015, a landmark report from the Institute of Medicine (now the National Academy of Medicine) described ME/CFS as a “serious, chronic, complex, systemic disease that often can profoundly affect the lives of patients.” Three years ago, the Centers for Disease Control and Prevention dropped its recommendations for graded exercise therapy and cognitive behavior therapy (CBT) as treatments for ME/CFS treatments — an implicit acknowledgement that the findings from research purporting to prove their effectiveness could not be trusted.

However, graded exercise therapy and cognitive behavior therapy have remained the dominant and deeply entrenched interventions for ME/CFS in the U.K., where this approach first emerged three decades ago. The two interventions have been nearly unquestioned as the official standard of care and routinely promoted at specialized clinics around the country. The most powerful voices in the medical and academic establishments have doggedly upheld and defended them. Until now.

 

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