Deary, V, Chalder, T, Sharpe, M · Clinical psychology review · 2007 · DOI
This review examines the theory that ME/CFS and similar conditions involve interactions between thinking patterns, stress responses, and behavior that keep symptoms going. Researchers looked at decades of research to see if cognitive behavioral therapy (a type of talking therapy focused on thoughts and behaviors) works for these conditions. The review suggests that multiple factors—including genetics, immune function, personality traits, and how people interpret their symptoms—likely work together in ways that current treatments may not fully address.
This review is important because it critically examines whether psychological models fully explain ME/CFS by acknowledging that multiple biological and psychological factors likely interact. For patients, this suggests that single-cause explanations (either purely medical or purely psychological) may be incomplete, supporting more integrative research approaches.
This review does not prove that psychological factors cause ME/CFS, nor does it establish that CBT is an effective primary treatment—it evaluates the plausibility of the model and reviews existing evidence. The narrative review design means it was not a systematic meta-analysis with standardized quality assessment, so conclusions about treatment efficacy are limited. It does not address whether abnormalities in ME/CFS-specific pathophysiology (immune dysfunction, post-exertional malaise, mitochondrial dysfunction) are adequately explained by the cognitive behavioral model.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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