Recovery from chronic fatigue syndrome: a systematic review—heterogeneity of definition limits study comparison

BackgroundPaediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a common illness with a major impact on quality of life. Recovery is poorly understood. Our aim was to describe definitions of recovery in paediatric CFS/ME, the rate of recovery and the time to recovery.MethodsThis systematic review included a detailed search of MEDLINE, EMBASE, PsycInfo and Cochrane Library between 1994 and July 2018. Inclusion criteria were (1) clinical trials and observational studies, (2) participants aged <19 years with CFS/ME, (3) conducted in Western Healthcare systems and (4) studies including a measure of recovery and time taken to recover.ResultsTwelve papers (10 studies) were identified, involving 826 patients (range 23–135). Recovery rates were highly varied, ranging between 4.5% and 83%.Eleven distinct definitions of recovery were used; six were composite outcomes while five used unidimensional outcomes. Outcome measures used to define recovery were highly heterogeneous. School attendance (n=8), fatigue (n=6) and physical functioning (n=4) were the most common outcomes included in definition of recovery. Only five definitions included a personal measure of recovery.ImplicationsDefinitions of recovery are highly variable, likely secondary to differences in study design, outcomes used, follow-up and study populations. Heterogeneous definitions of recovery limit meaningful comparison between studies, highlighting the need for a consensus definition going forward. Recovery is probably best defined from the child’s own perspective with a single self-reported measure. If composite measures are used for research, there should be agreement on the core outcome set used.

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What treatments work for anxiety in children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)? Systematic review

BMJ Open ◽

10.1136/bmjopen-2016-015481 ◽

2017 ◽

Vol 7 (9) ◽

pp. e015481 ◽

Cited By ~ 5

Author(s):

Sarah Victoria Ellen Stoll ◽

Esther Crawley ◽

Victoria Richards ◽

Nishita Lal ◽

Amberly Brigden ◽

...

Keyword(s):

Systematic Review ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Behavioural Therapy ◽

Myalgic Encephalomyelitis ◽

Cochrane Library ◽

Secondary Outcome ◽

Fatigue Syndrome ◽

Diagnostic Status ◽

Randomised Controlled

ObjectivesAnxiety is more prevalent in children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) than in the general population. A systematic review was carried out to identify which treatment methods are most effective for children with CFS and anxiety.DesignSystematic review using search terms entered into the Cochrane library and Ovid to search the databases Medline, Embase and psychINFO.ParticipantsStudies were selected if participants were <18 years old, diagnosed with CFS/ME (using US Centers for Disease Control and Prevention, the National Institute for Health and Care Excellence or Oxford criteria) and had a valid assessment of anxiety.InterventionsWe included observational studies and randomised controlled trials.ComparisonAny or none.OutcomesChange in anxiety diagnostic status and/or change in anxiety severity on a validated measure of anxiety from pretreatment to post-treatment.ResultsThe review identified nine papers from eight studies that met the inclusion criteria. None of the studies specifically targeted anxiety but six studies tested an intervention and measured anxiety as a secondary outcome. Of these studies, four used a cognitive behavioural therapy (CBT)-type approach to treat CFS/ME, one used a behavioural approach and one compared a drug treatment, gammaglobulin with a placebo. Three of the CBT-type studies described an improvement in anxiety as did the trial of gammaglobulin. As none of the studies stratified outcomes according to anxiety diagnostic status or severity, we were unable to determine whether anxiety changed prognosis or whether treatments were equally effective in those with comorbid anxiety compared with those without.ConclusionWe do not know what treatment should be offered for children with both anxiety and CFS/ME. Further research is therefore required to answer this question.Trial registration numberThis review was registered on Prospective Register of Systematic Review Protocols (PROSPERO) and the protocol is available fromhttp://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016043488.

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Are probiotic treatments useful on fibromyalgia syndrome or chronic fatigue syndrome patients? A systematic review

Beneficial Microbes ◽

10.3920/bm2017.0125 ◽

2018 ◽

Vol 9 (4) ◽

pp. 603-611 ◽

Cited By ~ 10

Author(s):

P. Roman ◽

F. Carrillo-Trabalón ◽

N. Sánchez-Labraca ◽

F. Cañadas ◽

A.F. Estévez ◽

...

Keyword(s):

Systematic Review ◽

Chronic Fatigue Syndrome ◽

Fibromyalgia Syndrome ◽

Chronic Fatigue ◽

Cochrane Library ◽

Pilot Studies ◽

Fatigue Syndrome ◽

Jadad Scale ◽

Inflammatory Processes ◽

Randomised Controlled

Evidence suggests that the gut microbiota might play an important role in fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS). Our goal is to systematically review the reported effect of probiotic treatments in patients diagnosed with FMS or CFS. A systematic review was carried out using 14 databases (PubMed, Cochrane Library, Scopus, PsycINFO, and others) in February 2016 to search for randomised controlled trials (RCTs) and pilot studies of CFS or FMS patient, published in the last ten years (from 2006 to 2016). The Jadad scale was used to asseverate the quality of the clinical trials considered. Two studies (n=83) met the inclusion criteria, which were performed in CFS patients and both studies were considered as a ‘High range of quality score’. The administration of Lactobacillus casei strain Shirota in CFS patients, over the course of 8 weeks, reduced anxiety scores. Likewise, this probiotic changed the faecal composition following 8 weeks of treatment. Additionally, the treatment with Bifidobacterium infantis 35624 in CFS patients, during the same period, reduced inflammatory biomarkers. The evidence about the usefulness of probiotics in CFS and FMS patients remains limited. The studied strains of probiotics have demonstrated a significant effect on modulating the anxiety and inflammatory processes in CFS patients. However, more experimental research, focusing mainly on the symptoms of the pathologies studied, is needed.

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Systematic Review of the Current Literature Related to Disability and Chronic Fatigue Syndrome: Evidence Report/Technology Assessment, Number 66

PsycEXTRA Dataset ◽

10.1037/e439642005-001 ◽

2002 ◽

Cited By ~ 1

Author(s):

Susan D. Ross ◽

Cindy Levine ◽

Nelson Ganz ◽

Diana Frame ◽

Rhonda Estok ◽

...

Keyword(s):

Systematic Review ◽

Chronic Fatigue Syndrome ◽

Current Literature ◽

Technology Assessment ◽

Chronic Fatigue ◽

Fatigue Syndrome

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A Systematic Review of Acupuncture and Moxibustion Treatment for Chronic Fatigue Syndrome in China

The American Journal of Chinese Medicine ◽

10.1142/s0192415x08005540 ◽

2008 ◽

Vol 36 (01) ◽

pp. 1-24 ◽

Cited By ~ 38

Author(s):

Tianfang Wang ◽

Qunhao Zhang ◽

Xiaolin Xue ◽

Albert Yeung

Keyword(s):

Systematic Review ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Future Studies ◽

Acupuncture And Moxibustion ◽

Fatigue Syndrome ◽

Collective Experience ◽

Rigorous Study ◽

The Common ◽

Study Designs

Studies on the treatment of chronic fatigue syndrome (CFS) with acupuncture and moxibustion in China were reviewed. All studies concluded the treatments were effective, with response rates ranging from 78.95% to 100%. However, the qualities of the studies were generally poor, and none of them used a RCT design. The common acupoints/sites used in the treatment of CFS, which may reflect the collective experience of acupuncturists in China based on Traditional Chinese Medicine theories can be used to evaluate the effectiveness of acupuncture for the treatment of CFS in future studies using more scientifically rigorous study designs.

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