Use and Perceived Helpfulness of Different Intervention Strategies in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Depression, 2026,Dorczok+

[SNT Gatchaman]

Use and Perceived Helpfulness of Different Intervention Strategies in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Depression

Spoiler: Authors

Dorczok, Marie Celine; Mossaheb, Nilufar; Mittmann, Gloria; Thomas, Marina F; Bartova, Lucie; Schrank, Beate; Steiner-Hofbauer, Verena

BACKGROUND
Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or depression both frequently report debilitating exhaustion, yet the two conditions differ in their etiological and diagnostic clarity, and clinical management. This study aimed to examine differences in the use and perceived helpfulness of a broad range of conventional treatments and complementary interventions, including nutritional approaches, between patients with ME/CFS and depression.

METHODS
A cross-sectional online survey was conducted in 2024. A total of 819 participants self-identified as having either ME/CFS (n = 576) or depression (n = 243). Participants (80% female) reported their use and perceived helpfulness of 52 treatments and interventions, encompassing behavioral therapies, medications, and dietary supplements. Group differences were examined using multivariate analyses of variance and covariance (MANOVA/MANCOVA). Open-ended responses were analyzed descriptively using thematic grouping and frequency counts.

RESULTS
Participants with depression most commonly reported the use of psychotherapy (M = 2.49, SD = 1.00) and antidepressant medication (M = 2.44, SD = 2.30), and they rated fewer interventions as helpful compared to participants with ME/CFS. In contrast, participants with ME/CFS reported a significantly broader engagement with diverse intervention modalities, particularly pacing (M = 2.73, SD = 0.80) and dietary supplements (M = 2.43, SD = 1.09), and perceived many of them as helpful. Group differences remained significant after controlling for age, gender, and whether treatment was medically recommended. Supplements targeting energy metabolism (e.g., CoQ10, NADH) were especially favored among ME/CFS participants.

CONCLUSIONS
Findings suggest that participants with ME/CFS tend to adopt an exploratory and expansive intervention approach, potentially reflecting the lack of standardized guidelines and limited effectiveness of available treatment options. Participants with depression, in contrast, appeared to follow more guideline-concordant, evidence-based treatment pathways. Taken together, the findings point to a need for further development and evaluation of empirically supported, patient-centered treatment and intervention strategies for ME/CFS and suggest differences in clinical care structures between ME/CFS and depression.

Web | DOI | PDF | Journal of Clinical Medicine | Open Access

 

[Utsikt]

Online recruitment and self-report so I don’t think the data is of much value.

Their reporting is «interesting»:

In contrast, participants with ME/CFS reported substantially more heterogeneous intervention patterns. Prevalence estimates indicated particularly high engagement in pacing (over 90%), dietary supplements (approximately 70%), relaxation or meditation techniques (approximately 80%), and dietary changes (approximately 50%). This distribution closely aligns with current clinical recommendations that emphasize pacing as a core management strategy for ME/CFS in the absence of curative or disease-modifying treatments [57]. At the same time, the high prevalence of complementary and self-directed strategies might reflect the limited availability of standardized, evidence-based treatment protocols and restricted access to specialized care for ME/CFS [24].

Importantly, although many interventions were frequently used, perceived helpfulness ratings were generally modest in both groups. Even for commonly applied strategies, only a minority of interventions reached higher helpfulness prevalence thresholds, underscoring the ongoing therapeutic uncertainty experienced by patients with both conditions [21,22]. These findings mirror prior research in ME/CFS populations, which consistently reports extensive trial-and-error treatment behavior combined with limited perceived benefit [24,70,71].

It’s striking that they don’t mention how physios, rehab and psychologists weren’t perceived as useful by most.

4.4. Contextual and Psychosocial Factors Shaping Treatment Engagement​

Beyond diagnostic group differences, treatment engagement was shaped by contextual and personal factors. Younger age and self-initiated use without medical recommendation were associated with higher supplement intake and perceived helpfulness, echoing previous findings that autonomy, expectancy effects, and health-related beliefs influence treatment perceptions [80,81,82].

Similar subgroup patterns, like stronger responses among patients with fatigue or orthostatic symptoms, have been reported by Eckey et al. [83], underscoring heterogeneity in DS responses and the need for subgroup-based analyses.

Illness representations and diagnostic labeling processes may further contribute to these patterns [84,85,86]. Individuals identifying with ME/CFS often conceptualize their condition as a systemic, somatic, and energy-related disorder, increasing the perceived plausibility of biologically oriented and metabolism-targeted interventions [28,87].

In contrast, individuals with depression may adopt a biopsychosocial illness model that aligns more closely with psychotherapy and pharmacotherapy, reinforcing adherence to guideline-based care [88,89].

Prior research on labeling effects and illness identity suggests that such frameworks strongly influence treatment expectations, engagement, and perceived helpfulness across chronic and stigmatized conditions [86,90,91,92,93].

Sure, it’s the framework that’s influencing it and not reality!