All in the mind? ME can be cured by counselling says professor

MANY patients with chronic fatigue syndrome are being held back by a ‘self-fulfilling prophecy’, according to a leading researcher.

Oxford psychiatrist Professor Michael Sharpe said that some people with the condition do not push themselves to recover.

His team today publishes findings which suggest a form of counselling is the most effective way to treat chronic fatigue syndrome, which is also known as ME.

The findings are likely to reignite the debate about whether it is a psychiatric condition or a physiological disease.

Professor Sharpe insisted that he views the condition to be ‘ a real illness’ with serious consequences. But he said patients become terrified of exercise and physical activity for fear that it will make their illness worse.

These fears can be overcome by cognitive behavioural therapy or a gradual increase in exercise, he said.

‘They get locked into a pattern where they do less, they get more concerned about doing more,’ he said. ‘If you live within your limits that becomes a self-fulfilling prophesy.’

The ME Association last night dismissed his claims as ‘bunkum’. Dr Charles Shepherd, medical adviser to the charity, said there is clear evidence the disease is rooted in neurological dysfunction and that cognitive behavioural therapy ‘has no role to play in the management of ME’.

Professor Sharpe’s team carried out a trial involving 641 patients, in which they found that cognitive behavioural therapy was more effective than standard medical treatment at treating the condition.

Gradually increasing the amount of exercise patients did also worked, according to results published today in the Lancet Psychiatry journal.

Some 250,000 people in Britain suffer from chronic fatigue syndrome, which comes with symptoms including flu-like illness, extreme tiredness and mental lethargy that can last for years.

The cause of the illness is unclear, provoking a debate that has lasted for decades.

Some experts think the disease is triggered by a virus, in a similar way to glandular fever.

But sceptics think it is merely a psychological condition, leading to a stigma that has led to sufferers being dismissed as having nothing more than ‘yuppie flu’.

Professor Sharpe, who conducted the study with experts from King’s College London and Queen Mary University of London, said he does not wish to diminish the severity of the dis- ease – and accepted that it is a serious condition.

‘Just because your condition gets better with rehabilitation does not mean it is not a real illness,’ he said.

But he said that the results seem to suggest that with help, people can get better.

‘It doesn’t seem to be a physical fitness mechanism,’ he said. ‘It seems to be overcoming concerns that doing more will make them worse and helps them to do more in a very gradual, structured way.

‘These rehabilitative treatments are not magic cures – but this is the only game in town in terms of evidence-based treatments.’

The team found that over 12 months cognitive behavioural therapy and graded exercise therapy achieved better outcomes than standard medical care, which usually includes pain relief and sleeping pills.

It was also more effective than ‘ pacing’ therapy – in which patients are encouraged to take regular breaks in their daily lives.

The researchers assessed most of the participants again after two and a half years, and found that the beneficial effects of therapy and exercise had been maintained over the longer term.

Cognitive behavioural therapy encourages patients to think differently about their symptoms.

Experts have spent decades searching for evidence that ME is a physiological disease. Definitive proof has never been found, but in February this year, scientists at Columbia University in New York, found a ‘distinct chemical footprint’ in the blood taken from hundreds of patients with the condition.