scholarly journals Predictors of outcome following treatment for chronic fatigue

2005 ◽  
Vol 186 (4) ◽  
pp. 350-351 ◽  
Author(s):  
Lucy Darbishire ◽  
Paul Seed ◽  
Leone Ridsdale
Keyword(s):  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Negative Consequences ◽  
Predictors Of Outcome ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Graded Exercise ◽  
Negative Effect ◽  
Baseline Characteristics

SummaryWe explored the role of baseline characteristics of 105 patients who presented with fatigue in primary care in determining outcome following either graded exercise or cognitive–behavioural therapy. Meeting the criteria for chronic fatigue syndrome was the most powerful predictor of poor outcome and this negative effect was enhanced by greater functional impairment or greater perceived negative consequences, but was not further enhanced by both.

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 The planning, implementation and publication of a complex intervention trial for chronic fatigue syndrome: the PACE trial

2015 ◽  
Vol 39 (1) ◽  
pp. 24-27 ◽  
Author(s):  
Peter D. White ◽  
Trudie Chalder ◽  
Michael Sharpe
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Medical Care ◽  
Physical Disability ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Intervention Trial ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Graded Exercise Therapy ◽  
Graded Exercise

SummaryThe PACE trial was a four-arm trial of specialist medical care, compared with specialist medical care with a supplementary therapy: adaptive pacing therapy, cognitive–behavioural therapy or graded exercise therapy, for patients with chronic fatigue syndrome. The trial found that both cognitive–behavioural and graded exercise therapies were more effective than either of the other two treatments in reducing fatigue and improving physical disability. This paper describes the design, conduct and main results of the trial, along with a description of the challenges that had to be overcome in order to produce clear answers to the clinically important questions the trial posed.

Myalgic encephalomyelitis/chronic fatigue syndrome patients’ reports of symptom changes following cognitive behavioural therapy, graded exercise therapy and pacing treatments: Analysis of a primary survey compared with secondary surveys

2017 ◽  
Vol 24 (10) ◽  
pp. 1318-1333 ◽  
Author(s):  
Keith Geraghty ◽  
Mark Hann ◽  
Stoyan Kurtev
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Exercise Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Myalgic Encephalomyelitis ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Graded Exercise Therapy ◽  
Graded Exercise

Cognitive behavioural therapy and graded exercise therapy are promoted as evidence-based treatments for myalgic encephalomyelitis/chronic fatigue syndrome. This article explores patients’ symptom responses following these treatments versus pacing therapy, an approach favoured by many sufferers. We analyse data from a large cross-sectional patient survey ( n = 1428) and compare our findings with those from comparable patient surveys ( n = 16,665), using a mix of descriptive statistics and regression analysis modelling. Findings from analysis of primary and secondary surveys suggest that cognitive behavioural therapy is of benefit to a small percentage of patients (8%–35%), graded exercise therapy brings about large negative responses in patients (54%–74%), while pacing is the most favoured treatment with the lowest negative response rate and the highest reported benefit (44%–82%).

Assessment of the scientific rigour of randomized controlled trials on the effectiveness of cognitive behavioural therapy and graded exercise therapy for patients with myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review

2019 ◽  
Vol 25 (2) ◽  
pp. 240-255 ◽  
Author(s):  
SA Ahmed ◽  
JC Mewes ◽  
HJM Vrijhoef
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Exercise Therapy ◽  
Methodological Quality ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Graded Exercise Therapy ◽  
Graded Exercise

Cognitive behavioural therapy and graded exercise therapy have been promoted as effective treatments for patients with myalgic encephalomyelitis/chronic fatigue syndrome. However, criticism on the scientific rigour of these studies has been raised. This review assessed the methodological quality of studies on the effectiveness of cognitive behavioural therapy and graded exercise therapy. The methodological quality of the 18 included studies was found to be relatively low, as bias was prominently found, affecting the main outcome measures of the studies (fatigue, physical functioning and functional impairment/status). Future research should focus on including more objective outcome measures in a well-defined patient population.

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.

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