Clinical Rheumatology

, Volume 30, Issue 3, pp 381–389 | Cite as

Health-related quality of life in patients with chronic fatigue syndrome: group cognitive behavioural therapy and graded exercise versus usual treatment. A randomised controlled trial with 1 year of follow-up

  • Montserrat NúñezEmail author
  • Joaquim Fernández-Solà
  • Esther Nuñez
  • José-Manuel Fernández-Huerta
  • Teresa Godás-Sieso
  • Esther Gomez-Gil
Original Article


Chronic fatigue syndrome (CFS) produces physical and neurocognitive disability that significantly affects health-related quality of life (HRQL). Multidisciplinary treatment combining graded exercise therapy (GET) cognitive behavioural therapy (CBT) and pharmacological treatment has shown only short-term improvements. To compare the effects on HRQL of (1) multidisciplinary treatment combining CBT, GET, and pharmacological treatment, and (2) usual treatment (exercise counselling and pharmacological treatment) at 12 months of follow-up. Prospective, randomized controlled trial with a follow-up of 12 months after the end of treatment. Patients consecutively diagnosed with CFS (Fukuda criteria) were randomly assigned to intervention (n = 60) or usual treatment (n = 60) groups. HRQL was assessed at baseline and 12 months by the Medical Outcomes Study Short-Form questionnaire (SF-36). Secondary outcomes included functional capacity for activities of daily living measured by the Stanford Health Assessment Questionnaire (HAQ) and comorbidities. At baseline, the two groups were similar, except for lower SF-36 emotional role scores in the intervention group. At 12 months, the intervention did not improve HRQL scores, with worse SF-36 physical function and bodily pain scores in the intervention group. Multidisciplinary treatment was not superior to usual treatment at 12 months in terms of HRQL. The possible benefits of GET as part of multidisciplinary treatment for CFS should be assessed on an individual patient basis.


Chronic fatigue syndrome Cognitive behavioural therapy Graded exercise therapy Health-related quality of life Outcomes 



We thank David Buss for his editorial advice.


Joaquim Fernandez-Solà received grants from the Generalitat of Catalonia, SGR 2009-1158, and CIBEROBN, Carlos III Health Institute, Majadahonda, Madrid.




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Copyright information

© Clinical Rheumatology 2011

Authors and Affiliations

  • Montserrat Núñez
    • 1
    • 6
    Email author
  • Joaquim Fernández-Solà
    • 2
  • Esther Nuñez
    • 3
  • José-Manuel Fernández-Huerta
    • 2
  • Teresa Godás-Sieso
    • 4
  • Esther Gomez-Gil
    • 5
  1. 1.Rheumatology ServiceFunctional Readaptation Unit, Hospital ClinicBarcelonaSpain
  2. 2.Department of Internal MedicineChronic Alcohol Unit, Hospital Clinic. Barcelona. CIBEROBN, Carlos III Health InstituteMadridSpain
  3. 3.Health Services, Catalan Health InstituteSAP Diagnostic and Treatment SupportBarcelonaSpain
  4. 4.Department of PsychologyChronic Alcohol Unit, Hospital ClinicBarcelonaSpain
  5. 5.Department of PsychiatryChronic Alcohol Unit, Hospital ClinicBarcelonaSpain
  6. 6.Department of RheumatologyHospital ClinicBarcelonaSpain

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