Cognitions, behaviours and co-morbid psychiatric diagnoses in patients with chronic fatigue syndrome

2012 ◽  
Vol 43 (2) ◽  
pp. 375-380 ◽  
Author(s):  
M. Cella ◽  
P. D. White ◽  
M. Sharpe ◽  
T. Chalder
Keyword(s):  
Anxiety Disorder ◽  
Chronic Fatigue Syndrome ◽  
Depressive Disorder ◽  
Anxiety Disorders ◽  
Social Adjustment ◽  
Chronic Fatigue ◽  
Depression And Anxiety ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Behavioural Factors

BackgroundSpecific cognitions and behaviours are hypothesized to be important in maintaining chronic fatigue syndrome (CFS). Previous research has shown that a substantial proportion of CFS patients have co-morbid anxiety and/or depression. This study aims to measure the prevalence of specific cognitions and behaviours in patients with CFS and to determine their association with co-morbid anxiety or depression disorders.MethodA total of 640 patients meeting Oxford criteria for CFS were recruited into a treatment trial (i.e. the PACE trial). Measures analysed were: the Cognitive Behavioural Response Questionnaire, the Chalder Fatigue Scale and the Work and Social Adjustment Scale. Anxiety and depression diagnoses were from the Structured Clinical Interview for DSM-IV. Multivariate analysis of variance was used to explore the associations between cognitive-behavioural factors in patients with and without co-morbid anxiety and/or depression.ResultsOf the total sample, 54% had a diagnosis of CFS and no depression or anxiety disorder, 14% had CFS and one anxiety disorder, 14% had CFS and depressive disorder and 18% had CFS and both depression and anxiety disorders. Cognitive and behavioural factors were associated with co-morbid diagnoses; however, some of the mean differences between groups were small. Beliefs about damage and symptom focussing were more frequent in patients with anxiety disorders while embarrassment and behavioural avoidance were more common in patients with depressive disorder.ConclusionsCognitions and behaviours hypothesized to perpetuate CFS differed in patients with concomitant depression and anxiety. Cognitive behavioural treatments should be tailored appropriately.

scholarly journals Cognitive behavioural therapy for chronic fatigue and chronic fatigue syndrome: outcomes from a specialist clinic in the UK

2020 ◽  
Vol 113 (10) ◽  
pp. 394-402
Author(s):  
James Adamson ◽  
Sheila Ali ◽  
Alastair Santhouse ◽  
Simon Wessely ◽  
Trudie Chalder
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Social Adjustment ◽  
Physical Functioning ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Uk

Objectives Cognitive behavioural therapy is commonly used to treat chronic fatigue syndrome and has been shown to be effective for reducing fatigue and improving physical functioning. Most of the evidence on the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome is from randomised control trials, but there are only a few studies in naturalistic treatment settings. Our aim was to examine the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic setting and examine what factors, if any, predicted outcome. Design Using linear mixed effects analysis, we analysed patients' self-reported symptomology over the course of treatment and at three-month follow-up. Furthermore, we explored what baseline factors were associated with improvement at follow-up. Setting Data were available for 995 patients receiving cognitive behavioural therapy for chronic fatigue syndrome at an outpatient clinic in the UK. Participants Participants were referred consecutively to a specialist unit for chronic fatigue or chronic fatigue syndrome. Main outcome measures Patients were assessed throughout their treatment using self-report measures including the Chalder Fatigue Scale, 36-item Short Form Health Survey, Hospital Anxiety and Depression Scale and Global Improvement and Satisfaction. Results Patients’ fatigue, physical functioning and social adjustment scores significantly improved over the duration of treatment with medium to large effect sizes (|d| = 0.45–0.91). Furthermore, 85% of patients self-reported that they felt an improvement in their fatigue at follow-up and 90% were satisfied with their treatment. None of the regression models convincingly predicted improvement in outcomes with the best model being (R2 = 0.137). Conclusions Patients’ fatigue, physical functioning and social adjustment all significantly improved following cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic outpatient setting. These findings support the growing evidence from previous randomised control trials and suggest that cognitive behavioural therapy could be an effective treatment in routine treatment settings.

scholarly journals Chronic fatigue syndrome: Comparing outcomes in White British and Black and minority ethnic patients after cognitive–behavioural therapy

2016 ◽  
Vol 209 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Tom Ingman ◽  
Sheila Ali ◽  
Kamaldeep Bhui ◽  
Trudie Chalder
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Social Adjustment ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Resting Behaviour ◽  
Cognitive Behavioural ◽  
The Uk ◽  
Minority Ethnic

BackgroundCognitive–behavioural therapy (CBT) is one of the most promising treatments for chronic fatigue syndrome (CFS). It is unclear whether CBT is effective for Black and minority ethnic (BME) groups.AimsTo assess the effectiveness of CBT in BME patients compared with White British patients presenting to a specialist CFS service.MethodData from 67 (19.0%) BME participants and 285 (81.0%) White British participants referred to a specialist CFS service in the UK were collected at baseline and after CBT treatment.ResultsPairwise comparisons revealed that both BME participants and White British participants significantly improved on measures of fatigue severity (P<0.001), physical functioning (P<0.001) and work/social adjustment (P<0.001). Independent samples t-tests showed that BME participants improved despite exhibiting significantly higher baseline damage beliefs (P = 0.009), catastrophising (P = 0.024), all-or-nothing behaviour (P = 0.036) and avoidance/resting behaviour (P = 0.001), compared with White British participants.ConclusionsTo our knowledge, this study is the first to indicate that CBT is effective for treating CFS in a group of patients from diverse BME backgrounds.

scholarly journals Investigating the effectiveness and cost-effectiveness of FITNET-NHS (Fatigue In Teenagers on the interNET in the NHS) compared to activity management to treat paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME): amendment to the published protocol

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Emma Anderson ◽  
Daisy Gaunt ◽  
Chris Metcalfe ◽  
Manmita Rai ◽  
William Hollingworth ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cost Effective ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
The Internet ◽  
Trial Protocol ◽  
Fatigue Syndrome ◽  
Therapy Program ◽  
Cognitive Behavioural ◽  
Activity Management

Abstract The FITNET-NHS Trial is a UK, national, trial investigating whether an online cognitive behavioural therapy program (FITNET-NHS) for treating chronic fatigue syndrome/ME in adolescents is clinically effective and cost-effective in the NHS. At the time of writing (September 2019), the trial was recruiting participants. This article presents an update to the planned sample size and data collection duration previously published within the trial protocol. Trial registration ISRCTN, ID: 18020851. Registered 8 April 2016.

scholarly journals Competences Required for the Delivery of High and Low-Intensity Cognitive Behavioural Interventions for Chronic Fatigue, Chronic Fatigue Syndrome/ME and Irritable Bowel Syndrome

2014 ◽  
Vol 42 (6) ◽  
pp. 760-764 ◽  
Author(s):  
Katharine A. Rimes ◽  
Janet Wingrove ◽  
Rona Moss-Morris ◽  
Trudie Chalder
Keyword(s):  
Irritable Bowel Syndrome ◽  
Chronic Fatigue Syndrome ◽  
High Intensity ◽  
Chronic Fatigue ◽  
Behavioural Interventions ◽  
Low Intensity ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Irritable Bowel ◽  
Cognitive Behavioural Interventions

Background: Cognitive behavioural interventions are effective in the treatment of chronic fatigue, chronic fatigue syndrome (sometimes known as ME or CFS/ME) and irritable bowel syndrome (IBS). Such interventions are increasingly being provided not only in specialist settings but in primary care settings such as Improving Access to Psychological Therapies (IAPT) services. There are no existing competences for the delivery of “low-intensity” or “high-intensity” cognitive behavioural interventions for these conditions. Aims: To develop “high-intensity” and “low-intensity” competences for cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS. Method: The initial draft drew on a variety of sources including treatment manuals and other information from randomized controlled trials. Therapists with experience in providing cognitive behavioural interventions for CF, CFS/ME and IBS in research and clinical settings were consulted on the initial draft competences and their suggestions for minor amendments were incorporated into the final versions. Results: Feedback from experienced therapists was positive. Therapists providing low intensity interventions reported that the competences were also helpful in highlighting training needs. Conclusions: These sets of competences should facilitate the training and supervision of therapists providing cognitive behavioural interventions for chronic fatigue, CFS/ME and IBS. The competences are available online (see table of contents for this issue: http://journals.cambridge.org/jid_BCP) or on request from the first author.

scholarly journals Assessing functioning in adolescents with chronic fatigue syndrome: psychometric properties and factor structure of the School and Social Adjustment Scale and the Physical Functioning Subscale of the SF36

2020 ◽  
Vol 48 (5) ◽  
pp. 546-556 ◽  
Author(s):  
M.E. Loades ◽  
S. Vitoratou ◽  
K.A. Rimes ◽  
T. Chalder
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychometric Properties ◽  
Social Adjustment ◽  
Physical Functioning ◽  
Chronic Fatigue ◽  
Factor Solution ◽  
Fatigue Syndrome ◽  
Functioning Subscale ◽  
Physical Functioning Subscale ◽  
Social Adjustment Scale

AbstractBackground:Chronic fatigue syndrome (CFS) has a major impact on functioning. However, no validated measures of functioning for this population exist.Aims:We aimed to establish the psychometric properties of the 5-item School and Social Adjustment Scale (SSAS) and the 10-item Physical Functioning Subscale of the SF-36 in adolescents with CFS.Method:Measures were completed by adolescents with CFS (n = 121).Results:For the Physical Functioning Subscale, a 2-factor solution provided a close fit to the data. Internal consistency was satisfactory. For the SSAS, a 1-factor solution provided an adequate fit to the data. The internal consistency was satisfactory. Inter-item and item-total correlations did not indicate any problematic items and functioning scores were moderately correlated with other measures of disability, providing evidence of construct validity.Conclusion:Both measures were found to be reliable and valid and provide brief measures for assessing these important outcomes. The Physical Functioning Subscale can be used as two subscales in adolescents with CFS.

Mood and Anxiety Disorders in Chronic Fatigue Syndrome, Fibromyalgia, and Irritable Bowel Syndrome

2015 ◽  
Vol 77 (4) ◽  
pp. 449-457 ◽  
Author(s):  
Karin A. M. Janssens ◽  
Wilma L. Zijlema ◽  
Monica L. Joustra ◽  
Judith G. M. Rosmalen
Keyword(s):  
Irritable Bowel Syndrome ◽  
Chronic Fatigue Syndrome ◽  
Anxiety Disorders ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
Mood And Anxiety Disorders ◽  
Irritable Bowel

The concept of ‘illness without disease’ impedes understanding of chronic fatigue syndrome: a response to Sharpe and Greco

2020 ◽  
pp. medhum-2019-011807
Author(s):  
Steven Lubet ◽  
David Tuller
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Medical Humanities ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Behavioural Interventions ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Graded Exercise Therapy ◽  
Objective Evidence ◽  
Graded Exercise

In a recent article in Medical Humanities, Sharpe and Greco characterise myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as an ‘illness without disease’, citing the absence of identified diagnostic markers. They attribute patients’ rejection of psychological and behavioural interventions, such as cognitive–behavioural therapy (CBT) and graded exercise therapy (GET), to a ‘paradox’ resulting from a supposed failure to acknowledge that ‘there is no good objective evidence of bodily disease’. In response, we explain that understandings about the causes of and treatments for medical complaints have shifted across centuries, and that conditions once thought to be ‘psychosomatic’ have later been determined to have physiological causes. We also note that Sharpe and Greco do not disclose that leading scientists and physicians believe that ME/CFS is a biomedical disease, and that numerous experts, not just patients, have rejected the research underlying the CBT/GET treatment approach. In conclusion, we remind investigators that medical classifications are always subject to revision based on subsequent research, and we therefore call for more humility before declaring categorically that patients are experiencing ‘illness without disease’.

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