Helping Teens With Chronic Fatigue Syndrome

Cognitive Behavior Therapy Helps Fatigue, Increases School Attendance, Say Dutch Researchers

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Dec. 7, 2004 -- Cognitive behavioral therapy help teens handle chronic fatigue syndrome, say Dutch researchers. However, it's not a cure. No one knows what causes chronic fatigue syndrome, let alone what cures it.

People with chronic fatigue syndrome are so drastically exhausted that they often can't lead normal lives. Rest doesn't help, and other illnesses don't explain it. Symptoms must last at least six months and must be accompanied by other symptoms, such as muscle pain and nonrestorative sleep, for chronic fatigue syndrome to be diagnosed.

The condition rarely affects children but it can occur in adolescence, particularly in young teenage girls.

Solutions have been elusive. Popular therapies have included exercise, massage, acupuncture, and special diets, but nothing has been shown to cure chronic fatigue syndrome. Cognitive behavior therapy has also been studied, but research only focused on adults before now.

In cognitive behavior therapy, people learn new ways to think about and cope with their problems. They also take action, developing and using strategies to improve their lives.

The new study included about 70 Dutch teens with chronic fatigue syndrome. Researchers looked to see whether this treatment might improve fatigue, functional impairment as a result of the condition, and school attendance.

Half of the teens with chronic fatigue syndrome were immediately assigned to cognitive behavior therapy. They agreed not to undertake any other treatments while in therapy. The remaining teens went on a wait list for cognitive therapy and were free to pursue other treatments.

Each person in the therapy group got 10 individual sessions over five months. The normally active teens focused on recognizing and accepting chronic fatigue's limitations, learning to be active without overdoing it. Those who were less active worked to become as active as possible, challenging any discouraging beliefs.

Parents also got involved. In families with younger patients, parents coached their children. For patients older than 15, parents were supportive while letting teens take responsibility for their treatment.

Therapy was a big help. At the end of the five-month study, the teens who received cognitive behavioral therapy had greater improvements in fatigue severity, physical functioning, and school attendance than those not receiving therapy.

Almost 60% of the therapy group returned to school full time. That's "an important indication of recovery," say the researchers. By the study's end, full-time school attendance was about twice as common in the therapy group than among the wait-listed patients.

"Cognitive behavior therapy is an effective treatment for chronic fatigue syndrome in adolescents," say the scientists. They included Maja Stulemeijer of the Expert Centre Chronic Fatigue at University Medical Center Nijmegen in the Netherlands. The study is published in the BMJ Online First.

Show Sources

SOURCES: Stulemeijer, M. BMJ Online First, Dec. 7, 2004. WebMD Medical Reference from Healthwise: "Chronic Fatigue Syndrome: Topic Overview." WebMD Medical Reference from Healthwise: "Chronic Fatigue Syndrome: Other Treatment." WebMD Medical News: "Behavior Therapy Helps Many Chronic Fatigue Patients." News release, BMJ.
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