[English translation of the statement in Dutch]
According to common opinion is Myalgic Encephalomyelitis (ME) / Chronic Fatigue Syndrome (CFS) a medically unexplained syndrome and is cognitive behavorial therapy (CBT), in combination with graded exercise therapy (GET), the only evidence-based effective therapy.
In an article in Tijdschrift voor Psychotherapie (July 2011), a Dutch scientific magazine for psychologists/psychotherapists, Twisk, Arnoldus and Maes substantiate that these claims are false.
Characteristic symptoms of ME/CFS, like exhaustion, pain, cognitive impairment and an aggravation of the various symptoms after minor exertion (post-exertional malaise), can (bio)logically be explained at large by various organical abnormalities, which have been found repeatedly in ME/CFS: immunological aberrations (amongst others intracellular inflammation), oxidative en nitrosative stress, hyperpermeability of the gut) and their sequels, mitochondrial dysfunction, hypoperfusion et cetera.
The evidence-based claim that CBT/GET is the only effective treatment for ME/CFS, which could result into recovery up to 70% of the patients, is false.
CBT/GET is not significantly more effective than standard medical care, and only results into subjective improvement in ±30% of people with “chronic fatigue” (not ME/CFS), which is not reflected in objective improvement, and by large not sufficient to qualify as moderate effective.
Even worse, CBT/GET has a potential negative effect in 30-50% of the ME/CFS patients.
The authors stress the need for a drastic change of direction, from the current psychological-oriented outlook towards a medical approach, aimed at:
- an objective and quick diagnosis, based upon clinical criteria;
- tests to objectively measure symptoms (e.g. repeated exercise tests) ;
- unraveling the demonstrated biological abnormalities in more detail
- in the ME/CFS patient group and subgroups thereof (based upon biomarkers);
- developing and testing pharmaceuticals, supplements etc. that reverse the biological abnormalities established in (individual) ME/CFS patients.