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The effect of cognitive behaviour therapy for chronic fatigue syndrome on self-reported cognitive impairments and neuropsychological test performance
  1. Hans Knoop1,
  2. Judith B Prins2,
  3. Maja Stulemeijer2,
  4. Jos W M van der Meer3,
  5. Gijs Bleijenberg1
  1. 1Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  2. 2Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  3. 3Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  1. Correspondence to:
 H Knoop
 Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, P O Box 9011, 6525 EC Nijmegen, The Netherlands; j.knoop{at}


Background: Patients with chronic fatigue syndrome (CFS) often have concentration and memory problems. Neuropsychological test performance is impaired in at least a subgroup of patients with CFS. Cognitive behavioural therapy (CBT) for CFS leads to a reduction in fatigue and disabilities.

Aim: To test the hypothesis that CBT results in a reduction of self-reported cognitive impairment and in an improved neuropsychological test performance.

Methods: Data of two previous randomised controlled trials were used. One study compared CBT for adult patients with CFS, with two control conditions. The second study compared CBT for adolescent patients with a waiting list condition. Self-reported cognitive impairment was assessed with questionnaires. Information speed was measured with simple and choice reaction time tasks. Adults also completed the symbol digit-modalities task, a measure of complex attentional function.

Results: In both studies, the level of self-reported cognitive impairment decreased significantly more after CBT than in the control conditions. Neuropsychological test performance did not improve.

Conclusions: CBT leads to a reduction in self-reported cognitive impairment, but not to improved neuropsychological test performance. The findings of this study support the idea that the distorted perception of cognitive processes is more central to CFS than actual cognitive performance.

  • CBT, cognitive behavioural therapy
  • CFS, chronic fatigue syndrome
  • CIS, checklist individual strength
  • CIS-conc, checklist individual strength-concentration
  • SDMT, symbol digit modalities task
  • SIP-ab, sickness impact profile-alertness behaviour
  • SOCI, self-observation of cognitive impairment

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  • Funding: The Health Insurance Council (College van Zorgverzekeraars) funded the adult CBT study. The Children’s Welfare Stamps Netherlands (Stichting Kinderpostzegels Nederland) and the ME Foundation (ME Stichting) funded the adolescent CBT study.

  • Competing interests: none.