Cognitive Behaviour Group Therapy for Chronic Fatigue Syndrome: A Non-Randomised Waiting List Controlled Study

Background: Meta-analyses have been inconclusive about the efficacy of cognitive behaviour therapies (CBTs) delivered in groups of patients with chronic fatigue syndrome (CFS) due to a lack of adequate studies. Methods: We conducted a pragmatic randomised controlled trial with 204 adult CFS patients from our routine clinical practice who were willing to receive group therapy. Patients were equally allocated to therapy groups of 8 patients and 2 therapists, 4 patients and 1 therapist or a waiting list control condition. Primary analysis was based on the intention-to-treat principle and compared the intervention group (n = 136) with the waiting list condition (n = 68). The study was open label. Results: Thirty-four (17%) patients were lost to follow-up during the course of the trial. Missing data were imputed using mean proportions of improvement based on the outcome scores of similar patients with a second assessment. Large and significant improvement in favour of the intervention group was found on fatigue severity (effect size = 1.1) and overall impairment (effect size = 0.9) at the second assessment. Physical functioning and psychological distress improved moderately (effect size = 0.5). Treatment effects remained significant in sensitivity and per-protocol analyses. Subgroup analysis revealed that the effects of the intervention also remained significant when both group sizes (i.e. 4 and 8 patients) were compared separately with the waiting list condition. Conclusions: CBT can be effectively delivered in groups of CFS patients. Group size does not seem to affect the general efficacy of the intervention which is of importance for settings in which large treatment groups are not feasible due to limited referral.

Section: Introductionmentioning

confidence: 99%

Randomised Controlled Trial of Cognitive Behaviour Therapy Delivered in Groups of Patients with Chronic Fatigue Syndrome

Wiborg¹,

Bussel²,

Dijk³

et al. 2015

“…We intentionally chose patients with chronic fatigue syndrome (CFS) because available treatment options for patients with CFS, such as cognitive behaviour therapy [19] or graded exercise therapy [20], are not generally effective [21, 22], or widely available and only used by some CFS patients because of their own individual attributional theories about this illness [23]. As patients with CFS are regularly seeking alternative treatments and may frequent healers, this would appear to be a reasonable intervention to evaluate.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Distant Healing for Patients with Chronic Fatigue Syndrome: A Randomised Controlled Partially Blinded Trial (EUHEALS)

Walach

Bösch²,

Lewith

et al. 2008

Background: Distant healing, a form of spiritual healing, is widely used for many conditions but little is known about its effectiveness. Methods: In order to evaluate distant healing in patients with a stable chronic condition, we randomised 409 patients with chronic fatigue syndrome (CFS) from 14 private practices for environmental medicine in Germany and Austria in a two by two factorial design to immediate versus deferred (waiting for 6 months) distant healing. Half the patients were blinded and half knew their treatment allocation. Patients were treated for 6 months and allocated to groups of 3 healers from a pool of 462 healers in 21 European countries with different healing traditions. Change in Mental Health Component Summary (MHCS) score (SF-36) was the primary outcome and Physical Health Component Summary score (PHCS) the secondary outcome. Results: This trial population had very low quality of life and symptom scores at entry. There were no differences over 6 months in post-treatment MHCS scores between the treated and untreated groups. There was a non-significant outcome (p = 0.11) for healing with PHCS (1.11; 95% CI –0.255 to 2.473 at 6 months) and a significant effect (p = 0.027) for blinding; patients who were unblinded became worse during the trial (–1.544; 95% CI –2.913 to –0.176). We found no relevant interaction for blinding among treated patients in MHCS and PHCS. Expectation of treatment and duration of CFS added significantly to the model. Conclusions: In patients with CFS, distant healing appears to have no statistically significant effect on mental and physical health but the expectation of improvement did improve outcome.

“…Several articles [19][20][21][22][23][24] focused on probably the most systematically studied form of therapy, the CBT (yet some may argue that the primacy belongs to Rational Emotive Behavior Therapy). Linden et al [19] confi rmed that CBT is an effective method to treat generalized anxiety disorder (GAD) in a study comparing CBT (36 patients), control contact group (36 patients), and CBT after contact control period.…”

Section: Cognitive-behavioral Therapymentioning

confidence: 99%

“…Finally, I found the authors' statement in the abstract that 'differences between control and treatment group are comparable to or larger than those reported in studies on antidepressant drugs' amazing, as this article does not deal with this comparison directly and does not summarize the literature on pharmacological treatment of GAD. Bazelmans et al [20] found only a trend that Cognitive Behavior Group Therapy had a positive effect on fatigue in chronic fatigue syndrome, a condition notoriously resistant to any treatment. Unfortunately, they used therapists with no prior experience with this condition, which may have hindered the success of Cognitive Behavior Group Therapy.…”

Section: Cognitive-behavioral Therapymentioning

confidence: 99%

Reflections on Relevance: <i>Psychotherapy and Psychosomatics</i> in 2005

Balon

2005

This article focuses on the mission and relevance of articles published in Psychotherapy and Psychosomatics in 2005. Four areas of articles relevant to the mission of Psychotherapy and Psychosomatics are reviewed: (1) new (psycho-)therapies; (2) cognitive-behavioral therapy; (3) new or newly defined psychopathology, and (4) the impact of or impairment due to various illnesses or treatments. In addition, other clinically important and relevant issues, such as the need for new treatments, suicide during psychotherapy, technological innovations used in psychotherapies and methodology of psychotherapy trials are discussed.