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

Abstract:

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.

Source: Dorczok MC, Mossaheb N, Mittmann G, Thomas MF, Bartova L, Schrank B, Steiner-Hofbauer V. Use and Perceived Helpfulness of Different Intervention Strategies in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Depression. J Clin Med. 2026 Jan 20;15(2):849. doi: 10.3390/jcm15020849. PMID: 41598786. https://www.mdpi.com/2077-0383/15/2/849 (Full text)

Re-analysis: 200 treatments by 4000 Long Covid/ME patients

I ranked 200+ treatments by effect scores and got a new Top 5

In 2023, a survey was run among 3,925 ME/CFS and Long Covid patients called TREATME. It asked patients which treatments they have tried and how they responded to it. It is by far the biggest survey of its kind. I am really grateful to Martha Eckey, a PharmD and patient herself, for collecting the data and to the Open Medicine Foundation for having helped her to analyze and publish it.

At the time I wasn’t very interested in the results, but I’ve since come to appreciate the severity of publication biases. Those retrospective “we treated x patients with treatment Y without blinding and without controls” only get published if there are positive results! This survey, on the other hand, would have been published regardless of any individual treatment results, making it significantly more trustworthy (although not as good as well-designed RCTs).

Read the rest of this article here: https://viralpersistence.substack.com/p/re-analyzing-the-treatme-survey?triedRedirect=true