Defining recovery in chronic fatigue syndrome: a critical review

Abstract

Given that the term "recovery" was often based on limited assessments and less than full restoration of health, other more precise and accurate labels (e.g., clinically significant improvement) may be more appropriate and informative. In keeping with common understandings of the term recovery, we recommend a consistent definition that captures a broad-based return to health with assessments of both fatigue and function as well as the patient's perceptions of his/her recovery status.

Cognitive-behavior therapy: why is it so vilified in the chronic fatigue syndrome community?

“…These points have been expressed in letters to the editor that dispute recovery-labeled outcomes in published behavioral intervention studies in CFS. [4,14] Finally, the majority of CBT studies relied on patient self-report and did not utilize more objective measures of recovery, such as return to work or school [15] or laboratory-based assessments (e.g. 6-min walk test).…”

“…[15] Whiting et al [16] in her review of behavioral intervention studies in CFS presented the logical possibility that patients' perceptions of improvement could be due to lowered expectations of their abilities, rather than objectively heightened functioning that might be expected from a treatment protocol that encourages increasing activity levels. There is some evidence to support this interpretation.…”

Reports of recovery in chronic fatigue syndrome may present less than meets the eye

“…The definitions of recovery in chronic fatigue syndrome (CFS) are numerous, as are the amount of intervention and naturalistic studies designed to assess illness recovery 1. In a recent systematic review of 22 studies, recovery percentages ranged from 0% to 66% 1.…”

“…In a recent systematic review of 22 studies, recovery percentages ranged from 0% to 66% 1. White et al report a recovery rate of 22% to 23% in their active behavioural intervention conditions.…”

Authors’ response to commentary by Twisk

“…We respond here to commentary by Twisk [1] on our article entitled ''Defining recovery in chronic fatigue syndrome: A critical review'' [2]. Our colleague presents a biomedical model of diagnosis and recovery that is interesting, but more hypothetical than practical given the current state of knowledge in CFS and ME.…”