Today's issue (September 19) of The Journal of the American Medical Association (JAMA) contains a review article that examines treatments for CFS. The authors, who examined 44 studies conducted from 1986-2000, conclude that cognitive behavioral therapy (CBT) and graded exercise therapy have shown promising results.
 
The issue also contains an editorial by Simon Wessely that states some people reading the review article "...may see the findings, especially related to the benefits of CBT, as confirming their prejudices as to the mental instability of patients with CFS. Such views are misguided, but undoubtedly still exist in the minds of some health care professionals and employers."

To view an abstract of the review article, go to  http://jama.ama-assn.org/cgi/content/short/286/11/1360 (please note that only subscribers can access the full text for free).

The review was based on evidence-based surveys of the medical literature by the U.S. Agency for Healthcare Research and Quality (AHRQ) and the U.K. National Health Service. AHRQ's press release on the report is highly misleading, as it claims exercise may help CFS patients without qualifying that it may also be harmful and cause severe relapses. The release also does not clarify that the exercise therapy looked at was graded activity under the supervision of a qualified rehabilitation professional, not exercise as it is commonly understood by the general public (running, walking, weightlifting, etc.).


 
CFIDS Association Response
The CFIDS Association of America has issued a statement in response to the JAMA article. To view the statement, go to the Association's web site at http://www.cfids.org/profresources/press-release-2001-006.asp . The Association is working on a number of other responses to counteract the possible effects of the article, including asking physicians/researchers to write letters to the editor of JAMA.

What You Can Do
The article has already been reported on by the Associated Press and Reuters news services, and that coverage is often reprinted in local newspapers. If you see coverage appear in your newspaper, please notify the Association (e-mail lmoseley@cfids.org). You can also help counteract misperceptions about the illness and treatment by responding. Send a letter to the editor pointing out that:

• Graded exercise therapy and CBT do not cure CFS.
  
• The goal of behavioral therapy is to help patients cope with their symptoms, and is used to treat other chronic physical illnesses such as heart disease and MS.
  
• Exercise as the general public would define it is harmful for CFS patients and results in severe relapses.
  
• Graded exercise can be helpful in improving some levels of function in some patients, but only when done under the supervision of a skilled rehabilitation professional familiar with CFS.
  

Letters to the media are most effective when they are polite, although we admit that this can be very difficult! Try writing your "mad" letter first to get it out of your system, then set it aside and write the constructive one that will be more likely to get published. Also, try to keep your letter to one page. Reporters and editors are more likely to read a short response.
 
You may use the text of the Association's statement as a guide if it is helpful. More information on exercise therapy and CBT to include is available at http://www.cfids.org/about-cfids/supportive-therapy.asp

Thank you for your assistance in educating others about CFIDS.

Renee Brehio
Director of Communications
The CFIDS Association of America