Predictors of outcome in a fatigued population in primary care following a randomized controlled trial

2003 ◽  
Vol 33 (2) ◽  
pp. 283-287 ◽  
Author(s):  
T. CHALDER ◽  
E. GODFREY ◽  
L. RIDSDALE ◽  
M. KING ◽  
S. WESSELY
Keyword(s):  
Primary Care ◽  
Social Adjustment ◽  
Illness Perceptions ◽  
Controlled Trial ◽  
Demographic Variables ◽  
Self Report ◽  
Behaviour Therapy ◽  
Randomized Controlled ◽  
Cognitive Behaviour ◽  
Illness Attribution

Background. The objective of this study was to examine factors that predicted outcome in a chronically fatigued group of patients who were randomized to cognitive behaviour therapy or counselling in primary care.Method. Illness perceptions, attributions, fatigue, disability and demographic variables were recorded at assessment and levels of fatigue and disability were measured at 6 months post randomization. Logistic regression was used to examine associations.Results. Factors that predicted a poor outcome (four or more on the fatigue questionnaire) were: poor social adjustment at assessment; the patients self-report that they had never seen the GP for an emotional reason; a physical illness attribution; and, a long perceived future illness duration.Conclusions. Patients who are more psychologically minded are more likely to improve with psychological treatments in primary care. General practitioners need to assess this before referring to an appropriate therapist.

Patients with medically unexplained physical symptoms experience of receiving treatment in a primary-care psychological therapies service: a qualitative study

2015 ◽  
Vol 8 ◽  
Author(s):  
Chloe Gerskowitch ◽  
Ian Norman ◽  
Katharine A. Rimes
Keyword(s):  
Primary Care ◽  
Social Adjustment ◽  
Physical Symptoms ◽  
Self Report ◽  
Behaviour Therapy ◽  
Medically Unexplained Physical Symptoms ◽  
Psychological Therapies ◽  
Cognitive Behaviour ◽  
Medically Unexplained ◽  
Unexplained Physical Symptoms

AbstractAs a pilot site under the primary-care Increasing Access to Psychological Therapies (IAPT) Long Term Condition/Medically Unexplained Physical Symptoms (MUPS) project, patients with MUPS were offered cognitive behaviour therapy (CBT)-based treatments or attendance at a mindfulness-based stress reduction (MBSR) programme. This study aimed to gain an understanding of the views and experiences of MUPS patients that received CBT-based therapy or MBSR within an IAPT service and to investigate the relationship between their experiences and health outcomes measured on self-report questionnaires. Thematic analysis was used to analyse data gathered via semi-structured interviews with 11 patients. Data collected from three self-report measures were considered in relation to key features of participants’ reported experiences and patterns identified. Four main themes emerged: (1) something needs to change; (2) making connections between physical symptoms and mood, thoughts or activities; (3) sharing experiences and feeling understood; and (4) reflections on treatment experience. Participants generally reported a positive experience of treatment and felt better able to cope with their symptoms, although treatment did not necessarily result in reliable change in symptoms as measured by the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Work and Social Adjustment Scale (WSAS). This novel model of treatment appears to be acceptable for this patient group although evaluation of the pilot should consider the ability of routinely used measures to capture the value of treatment to patients, including improved coping with symptoms.

GROUP COGNITIVE BEHAVIOUR THERAPY FOR ANGER: A PILOT STUDY

2003 ◽  
Vol 31 (1) ◽  
pp. 69-83 ◽  
Author(s):  
Ronald Siddle ◽  
Freda Jones ◽  
Fairuz Awenat
Keyword(s):  
Randomized Controlled Trial ◽  
Pilot Study ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Behaviour Therapy ◽  
Randomized Controlled ◽  
Cognitive Behaviour ◽  
Initial Appointment ◽  
The Difference ◽  
Group Cbt

Patients referred with anger problems often do not attend for treatment. The aim of this study was to determine if group Cognitive Behaviour Therapy (CBT) was feasible. Patients referred for help with their anger were assessed, given 6 sessions of group CBT and re-assessed. Of 119 patients referred, 49 (41%) did not attend the initial appointment. Patients who attended for interview were invited to participate in the group CBT. Only 11 patients (9%) of those referred for therapy attended for the full course of CBT. Thirty-four patients (29%) were exposed to at least one session of CBT, while 66 patients (56%) did not attend for any therapy. Patients who attended for some or all of the CBT treatment reported reductions in the frequency and intensity of their anger outbursts. There was also a significant reduction in measures of their anger traits. It could be concluded that group CBT is an appropriate way to deliver this therapy to patients with anger problems, but it is clear that many of those referred are ambivalent about therapy and will not attend. Figures are given that will allow the planning of a randomized controlled trial to evaluate the difference between individual and group based CBT for patients with anger problems.

scholarly journals The effect of counselling, graded exercise and usual care for people with chronic fatigue in primary care: a randomized trial

2012 ◽  
Vol 42 (10) ◽  
pp. 2217-2224 ◽  
Author(s):  
L. Ridsdale ◽  
M. Hurley ◽  
M. King ◽  
P. McCrone ◽  
N. Donaldson
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Controlled Trial ◽  
Chronic Fatigue ◽  
Anxiety And Depression ◽  
Behaviour Therapy ◽  
Fatigue Score ◽  
Graded Exercise Therapy ◽  
Cognitive Behaviour ◽  
Graded Exercise

BackgroundTo evaluate the effectiveness of graded exercise therapy (GET), counselling (COUNS) and usual care plus a cognitive behaviour therapy (CBT) booklet (BUC) for people presenting with chronic fatigue in primary care.MethodA randomized controlled trial in general practice. The main outcome measure was the change in the Chalder fatigue score between baseline and 6 months. Secondary outcomes included a measure of global outcome, including anxiety and depression, functional impairment and satisfaction.ResultsThe reduction in mean Chalder fatigue score at 6 months was 8.1 [95% confidence interval (CI) 6.6–10.4] for BUC, 10.1 (95% CI 7.5–12.6) for GET and 8.6 (95% CI 6.5–10.8) for COUNS. There were no significant differences in change scores between the three groups at the 6- or 12-month assessment. Dissatisfaction with care was high. In relation to the BUC group, the odds of dissatisfaction at the 12-month assessment were less for the GET [odds ratio (OR) 0.11, 95% CI 0.02–0.54, p=0.01] and COUNS groups (OR 0.13, 95% CI 0.03–0.53, p=0.004).ConclusionsOur evidence suggests that fatigue presented to general practitioners (GPs) tends to remit over 6 months to a greater extent than found previously. Compared to BUC, those treated with graded exercise or counselling therapies were not significantly better with respect to the primary fatigue outcome, although they were less dissatisfied at 1 year. This evidence is generalizable nationally and internationally. We suggest that GPs ask patients to return at 6 months if their fatigue does not remit, when therapy options can be discussed further.

Sign in / Sign up

Export Citation Format

Share Document