A high drop-out rate of cognitive behavioural therapy for chronic fatigue – a comment on Adamson et al.

2021 ◽  
pp. 014107682110167
Author(s):  
Michiel Tack
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Drop Out Rate ◽  
Cognitive Behavioural

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

scholarly journals Computerised cognitive-behavioural therapy for depression: systematic review

2008 ◽  
Vol 193 (3) ◽  
pp. 181-184 ◽  
Author(s):  
Eva Kaltenthaler ◽  
Glenys Parry ◽  
Catherine Beverley ◽  
Michael Ferriter
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Treatment Options ◽  
Computer Software ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Potential Range ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Depression Education

BackgroundComputerised cognitive–behavioural therapy (CCBT) is used for treating depression and provides a potentially useful alternative to therapist cognitive–behavioural therapy (CBT).AimsTo systematically review the evidence for the effectiveness of CCBT for the treatment of mild to moderate depression.MethodElectronic databases were searched to identify randomised controlled trials. Selected studies were quality assessed and data extracted by two reviewers.ResultsFour studies of three computer software packages met the inclusion criteria. Comparators were treatment as usual, using a depression education website and an attention placebo.ConclusionsThere is some evidence to support the effectiveness of CCBT for the treatment of depression. However, all studies were associated with considerable drop-out rates and little evidence was presented regarding participants' preferences and the acceptability of the therapy. More research is needed to determine the place of CCBT in the potential range of treatment options offered to individuals with depression.

scholarly journals Does Starting With the Behavioural Component of Cognitive Behavioural Therapy (CBT) Increase Patients’ Retention in Therapy?

2012 ◽  
Vol 29 (4) ◽  
pp. 238-257 ◽  
Author(s):  
Nusrat Yasmeen Ahmed ◽  
Sharon Lawn
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Drop Out ◽  
Psychosocial Assessment ◽  
Anxiety And Depression ◽  
Behavioural Intervention ◽  
Behavioural Interventions ◽  
Comorbid Anxiety ◽  
Cognitive Behavioural ◽  
Different Types

This study examined whether starting with the behavioural component of cognitive behavioural therapy (CBT) decreases the drop-out rate in outpatients with comorbid anxiety and depression. Retrospective data were collected on 60 patients with anxiety and depression. Mean values of different psychosocial assessment scales during screening, mid-session and discharge session were compared between the patients receiving and not receiving any type of behavioural interventions and among the patients receiving different types of behavioural interventions. A significant relationship was found (p < .05) between behavioural interventions and retention in therapy. Patients who did not receive any sort of behavioural intervention showed a greater rate of drop-out than those who received behavioural interventions. In the group of patients receiving different types of behavioural interventions, there was significant improvement in mental health scores between the screening and discharge sessions in those who received exposure therapy. The study findings will be helpful to retain patients with comorbid anxiety and depression in an outpatient therapy setting. If patient retention is increased, CBT can be more effectively delivered and thereby achieve better health outcomes for patients, more effective use of therapy service resources, and decrease the socioeconomic burden of anxiety and depression on the community.

scholarly journals Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome

2005 ◽  
Vol 187 (2) ◽  
pp. 184-185 ◽  
Author(s):  
Judith Prins ◽  
Gijs Bleijenberg ◽  
Eufride Klein Rouweler ◽  
Jos Van Der Meer
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychiatric Disorders ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Psychiatric Diagnoses ◽  
Psychiatric Interview ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Impact

SummaryPsychiatric disorders have been associated with poor outcome in individuals with chronic fatigue syndrome (CFS). This study examines the impact of psychiatric disorders on outcome of cognitive-behavioural therapy (CBT). Psychiatric diagnoses were assessed with a structured psychiatric interview in a CBT trial of 270 people with CFS. Lifetime and current psychiatric disorders were found in 50 and 32% respectively. No significant differences in fatigue severity and functional impairment following treatment were found between participants with and without psychiatric diagnoses.

scholarly journals RESPONSE TO ADAMSON ET AL. (2020): “COGNITIVE BEHAVIOURAL THERAPY FOR CHRONIC FATIGUE AND CHRONIC FATIGUE SYNDROME: OUTCOMES FROM A SPECIALIST CLINIC IN THE UK”

2021 ◽  
Author(s):  
Brian Hughes ◽  
David Tuller
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Scientific Publication ◽  
Behavioural Therapy ◽  
Control Group ◽  
Fatigue Syndrome ◽  
Sample Attrition ◽  
Cognitive Behavioural ◽  
The Uk

In this review, we consider the paper by Adamson et al., published in the October 2020 issue of the Journal of the Royal Society of Medicine. The authors interpret their data as revealing significant improvements following cognitive behavioural therapy in a large sample of patients with chronic fatigue syndrome and chronic fatigue. Overall, the research is hampered by several fundamental methodological limitations that are not acknowledged sufficiently, or at all, by the authors. These include: (a) sampling ambiguity; (b) weak measurement; (c) survivor bias; (d) missing data; and (e) lack of a control group. In particular, the study is critically hampered by sample attrition, rendering the presentation of statements in the Abstract misleading with regard to points of fact, and, in our view, urgently requiring a formal published correction. In light of the fact that the paper was approved by multiple peer-reviewers and editors, we reflect on what its publication can teach us about the nature of contemporary scientific publication practices.

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