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Behav. Sci. 2017, 7(3), 52; doi:10.3390/bs7030052

FITNET’s Internet-Based Cognitive Behavioural Therapy Is Ineffective and May Impede Natural Recovery in Adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. A Review

1
Biochemist, London TW11, UK
2
Family Physician, Soerabaja Research Center, 1096 HH Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Received: 6 April 2017 / Revised: 6 June 2017 / Accepted: 2 August 2017 / Published: 11 August 2017
View Full-Text   |   Download PDF [277 KB, uploaded 15 August 2017]

Abstract

The Dutch Fatigue In Teenagers on the interNET (FITNET) study claimed that after 6 months, internet based cognitive behaviour therapy in adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), led to a 63% recovery rate compared to 8% after usual care, and that this was maintained at long term follow up (LTFU). Our reanalysis shows that their post-hoc definition of recovery included the severely ill, the unblinded trial had no adequate control group and it used lax selection criteria as well as outcomes assessed via questionnaires rather than objective outcomes, further contributing to exaggerated recovery figures. Their decision not to publish the actometer results might suggest that these did not back their recovery claims. Despite these bias creating methodological faults, the trial still found no significant difference in recovery rates (“~60%”) at LTFU, the trial’s primary goal. This is similar to or worse than the documented 54–94% spontaneous recovery rates within 3–4 years, suggesting that both FITNET and usual care (consisting of cognitive behaviour and graded exercise therapies) are ineffective and might even impede natural recovery in adolescents with ME/CFS. This has implications for the upcoming costly NHS FITNET trial which is a blueprint of the Dutch study, exposing it to similar biases. View Full-Text
Keywords: chronic fatigue syndrome; FITNET Trial; cognitive behaviour therapy; graded exercise therapy; internet-based cognitive behavioural therapy; myalgic encephalomyelitis; recovery chronic fatigue syndrome; FITNET Trial; cognitive behaviour therapy; graded exercise therapy; internet-based cognitive behavioural therapy; myalgic encephalomyelitis; recovery
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Ghatineh, S.; Vink, M. FITNET’s Internet-Based Cognitive Behavioural Therapy Is Ineffective and May Impede Natural Recovery in Adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. A Review. Behav. Sci. 2017, 7, 52.

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