The effect of cognitive behaviour therapy for chronic fatigue syndrome on self-reported cognitive impairments and neuropsychological test performance Hans Knoop, Judith B Prins, Maja Stulemeijer, Jos W M van der Meer, and Gijs Bleijenberg http://www.ncbi.nlm.nih.gov/pubmed/20047707 Abstract Background Patients with chronic fatigue syndrome (CFS) often have concentration and memory problems. Neuropsychological test performance is impaired in at least a subgroup of patients with CFS. Cognitive behavioural therapy (CBT) for CFS leads to a reduction in fatigue and disabilities. Aim To test the hypothesis that CBT results in a reduction of self?reported cognitive impairment and in an improved neuropsychological test performance. Methods Data of two previous randomised controlled trials were used. One study compared CBT for adult patients with CFS, with two control conditions. The second study compared CBT for adolescent patients with a waiting list condition. Self?reported cognitive impairment was assessed with questionnaires. Information speed was measured with simple and choice reaction time tasks. Adults also completed the symbol digit?modalities task, a measure of complex attentional function. Results In both studies, the level of self?reported cognitive impairment decreased significantly more after CBT than in the control conditions. Neuropsychological test performance did not improve. Conclusions CBT leads to a reduction in self?reported cognitive impairment, but not to improved neuropsychological test performance. The findings of this study support the idea that the distorted perception of cognitive processes is more central to CFS than actual cognitive performance. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077788/ They don't actually give us the results from the tests though, to let us see how they compare to healthy controls. They talk as if 'CBT is great because these patients are too worried about neuropsychological problems', but don't address how serious those problems actually are, and how concerned about them it would be reasonable to be! (The paper isn't really worth reading - they've barely put any of the data from their study in to it - I hate it when researchers do that). These are the tests they use: Neuropsychological tests Reaction time task The reaction time task consisted of two subtests, simple and choice reaction time tasks. Both are described in detail elsewhere.8,15 In a previous study, the reaction times of patients with CFS were slower than that of healthy controls on both tasks.8 Symbol digit modalities task The symbol digit modalities task (SDMT)16 was used in the adult study as a measure of complex attention. In previous studies, patients with CFS scored lower than a matched healthy control group.8,9 It's another example of CBT being great at getting patients to answer questionnaires in a more 'healthy' manner, but not so good at actually reducing disability. I get the impression that for a lot of doctors, they mainly want CFS patients to complain less... that's their priority for any treatment!