OBJECTIVES: The purpose of this work was to assess the long-term outcome of 
adolescents with chronic fatigue syndrome who received cognitive behavioral 
therapy and to determine the predictive value of fatigue severity and physical 
impairments of the adolescent and the fatigue severity of the mother at baseline 
for the outcome of the treatment at follow-up.
PATIENTS AND METHODS: Sixty-six adolescent patients with chronic fatigue 
syndrome who previously participated in a randomized, controlled trial that 
showed that cognitive behavioral therapy was more effective than a waiting-list 
condition in reducing fatigue and improving physical functioning were contacted 
for a follow-up assessment. Fifty participants of the follow-up study had 
received cognitive behavioral therapy for chronic fatigue syndrome (32 formed 
the cognitive behavioral therapy group in the original trial, and 18 patients 
received cognitive behavioral therapy after the waiting period). The remaining 
16 patients had refused cognitive behavioral therapy after the waiting period. 
The main outcome measures were fatigue severity (Checklist Individual Strength), 
physical functioning (Short-Form General Health Survey), and school attendance.
RESULTS: Data were complete for 61 patients at follow-up (cognitive behavioral 
therapy group: 47 patients; no-treatment group: 14 patients). The mean follow-up 
time was 2.1 years. There was no significant change in fatigue severity between 
posttreatment and follow-up in the cognitive behavioral therapy group. There was 
a significant further increase in physical functioning and school attendance 
(10% increase). The adolescents in the cognitive behavioral therapy group were 
significantly less fatigued and significantly less functionally impaired and had 
higher school attendance at follow-up than those in the no-treatment group. 
Fatigue severity of the mother was a significant predictor of treatment outcome.
CONCLUSIONS: The positive effects of cognitive behavioral therapy in adolescents 
with chronic fatigue syndrome are sustained after cognitive behavioral therapy. 
Higher fatigue severity of the mother predicts lower treatment outcome in 
adolescent patients.