Customizing treatment of chronic fatigue syndrome and fibromyalgia: the role of perpetuating factors

Psychosomatics. Nov-Dec 2008;49(6):470-7. doi: 10.1176/appi.psy.49.6.470.


Background: Syndromes characterized by chronic, medically unexplained fatigue, effort- and stress-intolerance, and widespread pain are highly prevalent in medicine.

Results: In chronic fatigue syndrome (CFS) and fibromyalgia (FM), various perpetuating factors may impair patients' quality of life and functioning and impede recovery. Although cognitive-behavioral and graded-exercise therapy are evidence-based treatments, the effectiveness and acceptability of therapeutic interventions in CFS/FM may largely depend on a customized approach taking the heterogeneity of perpetuating factors into account.

Conclusion: Further research should clarify the aim and outcome of different treatment strategies in CFS/FM, as well as the underlying mechanisms of change, including those facilitating neurobiological recovery.

Publication types

  • Review

MeSH terms

  • Adaptation, Psychological
  • Cognitive Behavioral Therapy / methods
  • Disease Management
  • Exercise Therapy / methods
  • Fatigue Syndrome, Chronic / drug therapy
  • Fatigue Syndrome, Chronic / psychology
  • Fatigue Syndrome, Chronic / therapy*
  • Fibromyalgia / drug therapy
  • Fibromyalgia / psychology
  • Fibromyalgia / therapy*
  • Humans
  • Randomized Controlled Trials as Topic