Psychiatric management of severe somatoform disorders in childhood and adolescence

2002 ◽  
Vol 14 (2) ◽  
pp. 85-89 ◽  
Author(s):  
M. Elena Garralda
Keyword(s):  
Somatoform Disorders ◽  
Treatment Strategies ◽  
Conversion Disorder ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Childhood And Adolescence ◽  
Beneficial Effects ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Assessment And Treatment

Background:Unexplained medical symptoms are common in children. They constitute the main feature of somatoform disorders of childhood (i.e. pain disorders, conversion disorder and chronic fatigue syndrome or neurasthenia).Objective:To describe assessment and treatment strategies for severe somatoform disorders of childhood.Methods:Review of recommendations for clinical practice and clinical trials.Results:A number of specific techniques have been described. Clinical accounts indicate that many children benefit and can recover. There is some empirical evidence supporting the beneficial effects of techniques such as family cognitive-behavioural therapy and relaxation technique for the less severe disorders.Conclusions:Existing helpful clinical guidelines require empiric validation.

scholarly journals ‘It’s personal to me’: A qualitative study of depression in young people with CFS/ME

2016 ◽  
Vol 22 (2) ◽  
pp. 326-340 ◽  
Author(s):  
Anna K Taylor ◽  
Maria Loades ◽  
Amberly LC Brigden ◽  
Simon M Collin ◽  
Esther Crawley
Keyword(s):  
Young People ◽  
Treatment Strategies ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Structured Interviews ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Impact ◽  
The Relationship ◽  
Probable Depression

Background: Paediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) has a prevalence of 0.4–2.4% and is defined as ‘generalised disabling fatigue persisting after routine tests and investigations have failed to identify an obvious underlying cause’. One-third of young people with CFS/ME have probable depression. Little is known about why depression develops, the relationship between depression and CFS/ME, or what treatment might be helpful. Methods: We conducted nine semi-structured interviews with young people with CFS/ME (aged 13–17 years, 8/9 female) and probable depression, covering perceived causes of depression, the relationship between CFS/ME and depression, and treatment strategies. Results: Most thought CFS/ME caused depression. Many discussed a cyclical relationship: low mood made CFS/ME worse. A sense of loss was common. CFS/ME restricted activities participants valued and changed systemic structures, causing depression. There was no single helpful treatment approach. Individualised approaches using combinations of cognitive behavioural therapy (CBT), medication, activity management and other strategies were described. Conclusion: This study suggests that depression may be secondary to CFS/ME in young people because of the impact of CFS/ME on quality of life. Clinicians treating young people with CFS/ME need to consider strategies to prevent development of depression, and research is needed into approaches that are effective in treating CFS/ME with co-morbid depression.

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.

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’.

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.

White matter changes following cognitive behavioural therapy in patients with chronic fatigue syndrome

NeuroImage ◽  
2009 ◽  
Vol 47 ◽  
pp. S55
Author(s):  
J. Scholz ◽  
F.P. De Lange ◽  
J.W. van der Meer ◽  
G. Bleijenberg ◽  
P. Hagoort ◽  
...  
Keyword(s):  
White Matter ◽  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
White Matter Changes ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural
Sign in / Sign up

Export Citation Format

Share Document