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Response to the editorial by Dr Geraghty.

Peter D White1,2, Trudie Chalder3, Michael Sharpe4

  • 11 Queen Mary University of London, UK.

Journal of Health Psychology
|August 15, 2017
PubMed
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The PACE trial found that cognitive behaviour therapy and graded exercise therapy were effective treatments for chronic fatigue syndrome. These therapies, when added to specialist medical care, proved safer and more beneficial than adaptive pacing or specialist care alone.

Area of Science:

  • Medicine
  • Psychology
  • Rehabilitation

Background:

  • Chronic fatigue syndrome (CFS) presents complex treatment challenges.
  • Previous research has explored various therapeutic approaches for CFS.
  • The adaptive Pacing, graded Activity and Cognitive behaviour therapy; a randomised Evaluation (PACE) trial aimed to compare different treatment modalities.

Purpose of the Study:

  • To respond to criticisms of the PACE trial findings.
  • To clarify misunderstandings regarding the trial's methodology and results.
  • To reaffirm the efficacy of specific treatments for CFS.

Main Methods:

  • The PACE trial was a randomized evaluation comparing four treatment arms for CFS.
  • Treatments included adaptive pacing therapy, graded exercise therapy, cognitive behaviour therapy, and specialist medical care alone.
Keywords:
chronic fatigue syndromeclinical trialscognitive behaviour therapygraded exercise therapytreatment

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  • All participants received specialist medical care as a baseline.

    • Main Results:

    • Adding cognitive behaviour therapy or graded exercise therapy to specialist medical care was found to be safe and effective.
    • These combined therapies were more effective than adaptive pacing therapy or specialist medical care alone.
    • The study addresses and refutes challenges to these findings.

    Conclusions:

    • Cognitive behaviour therapy and graded exercise therapy are effective and safe additions to specialist medical care for CFS.
    • The PACE trial's findings provide robust evidence supporting these therapeutic interventions.
    • Misinterpretations of the PACE trial data are addressed and corrected.