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Customizing Treatment of Chronic Fatigue Syndrome and Fibromyalgia: The Role of Perpetuating Factors

Received October 4, 2007; revised December 13, 2007; accepted January 2, 2008. From Dienst Liaisonpsychiatrie, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. Send correspondence and reprint requests to Dr. Boudewijn Van Houdenhove. e-mail: boudewijn.vanhoudenhove{at}uz.kuleuven.ac.be
© 2008 The Academy of Psychosomatic Medicine

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.

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