eg: Can General Practitioners Manage Chronic Fatigue Syndrome?A Controlled Trial Lisa Whitehead, Peter Campion 12/2011; 10(1):55-64. ABSTRACT Abstract Background: Chronic Fatigue Syndrome/Myalgic En-cephalomyeltis (CFS/ME) is now recognised as a condition that results in substantial disability with a prevalence of around 0.6%. Aim: The study aimed to test the hypotheses that general practitioners could (a) diagnose and (b) treat patients with the Chronic Fatigue Syndrome (CFS). Method: All practices in two health authorities were contacted with a 35% uptake. Fifty percent of practices then entered a patient into the study. Practices were randomised to either intervention or control groups, and were encouraged to recruit patients. It was intended that the intervention practices would introduce a form of brief cognitive behavioural therapy. Control practices were invited to manage their patients as usual, which often included referral to secondary care. Results: The study suffered from both poor recruitment and high drop out. However, we were able to show that this intervention had no effect on the illness of the patients enrolled, and that patients with CFS remained highly disabled over the 12 month study period, whatever their treatment. Conclusion: The study suggests that general practitioners in this study were unable to effectively treat the condition. This accords with the Royal Colleges' report (1996), that the only evidence for effective treatment thus far has come from specialist units. The study suggests that general practitioners are unable to provide a management programme of this nature, and possibly effective treatment programmes for CFS in primary care. Long-term efficacy of cognitive-behavioral therapy by general practitioners for fatigue: a 4-year follow-up study. Stephanie S Leone, Marcus J H Huibers, Ijmert Kant, Ludovic G P M van Amelsvoort, Constant P van Schayck, Gijs Bleijenberg, J André Knottnerus Department of Epidemiology, Maastricht University, Maastricht, The Netherlands. Journal of Psychosomatic Research (Impact Factor: 3.27). 12/2006; 61(5):601-7. DOI:10.1016/j.jpsychores.2006.04.010 Source: PubMed ABSTRACT In an earlier study, we found that cognitive-behavioral therapy (CBT) delivered by general practitioners (GPs) for fatigue among employees on sick leave was not effective after 12 months. In this study we aim to assess the long-term efficacy of CBT by GPs for fatigue. It was hypothesized that the intervention could prevent deterioration as well as relapse of fatigue complaints and relapse into absenteeism in the long term. Patients who participated in the original randomized controlled trial were followed up 4 years later. Fatigue and absenteeism were the main outcomes. Fatigue and absenteeism were high in the intervention and control groups at the 4-year follow-up. There was no significant difference between the intervention group and the control group on fatigue and absenteeism. The intervention group however tended toward less-favorable outcomes as compared with the control group. Like that of chronic fatigue syndrome, the prognosis of less-advanced fatigue is rather poor. CBT delivered by GPs is not effective in the long term. To me, it seems quite possible that it's that GPs doing CBT are less able to induce response bias in patients which is causing the null results, as presumably they can receive similar training to that provided to those training to do CBT. These studies often seem to not be mentioned in assessments of the evidence for CBT for CFS. (I'm not sure that this thread is anything more than a note for myself).