Patient education to encourage graded exercise in chronic fatigue
syndrome - 2-year follow-up of randomised controlled trial

The British Journal of Psychiatry (2004) 184: 142-146

Pauline Powell, PhD, Richard P. Bentall, PhD, Fred J. Nye, MD
FRCP and Richard H. T. Edwards, MB PhD FRCP

Department of Psychology, University of Manchester, UK

Correspondence: Professor Richard Bentall, Department of
Psychology,University of Manchester, Oxford Road, Manchester M13 9PL,UK.
E-mail: bentall@psy.man.ac.uk

Declaration of interest: None.


Background: An earlier trial demonstrated good outcomes after 1 year for
patients with chronic fatigue syndrome (CFS) who received an educational
intervention designed to encourage graded activity.

Aims: To determine 2-year outcomes for the same treated patients and the
response to treatment of patients formerly in the control condition.

Method: Patients in the treatment groups (n=114) were followed up at 2
years; 32 patients from the control group were offered the intervention
after 1 year and were assessed 1 year later. Assessments were the
self-rated measures used in the original trial.

Results: At 2 years 63 of the treated patients (55%) no longer fulfilled
trial criteria for CFS compared with 64 patients (56%) at 1 year.
Fourteen of 30 crossover patients (47%) achieved a good outcome at 1 year
and seven (23%) no longer fulfilled criteria for CFS.

Conclusions: Benefits of the intervention were maintained at 2 years.
Delaying treatment is associated with reduced efficacy and required more
intensive therapy.


© 2004 The Royal College of Psychiatrists