Fatigue Management in Patients with Sarcoidosis Using Group CBT

Abstract

Sarcoidosis is a systemic granulomatous disease. At present, the issue of etiology of the disease has not yet been answered. The treatment of choice is corticosteroid therapy; new trends include biological treatment. Stress and overload often occur in the early stages, and depression and anxiety are added during the course of the disease. 50-70% of patients complain of fatigue, which affects the quality of their life even after the disappearance of other symptoms. Cognitive Behavioral Therapy (CBT) is recommended as the most suitable therapy for fatigue-it affects the anxiety and symptoms of depression and thus indirectly affects the fatigue (25, 27). In our work, we used group CBT to influence fatigue. Group therapy lasted for 6 weeks. We set up a group of 14 patients who complained of fatigue during the reporting period. Patients completed the BDI-II and FAS questionnaires before starting the therapy, after six weeks and after one year. The results show that after six weeks there was no reduction in fatigue and depression, but after one year there was a statistically significant difference between the patient group and control group: in the patient group, the overall score decreased slightly on average (reduction of fatigue and depression), in the control group, the overall score increased significantly (worsening of fatigue and depression). The greatest benefit of this study is the establishment of the Sarcoidosis Club, which meets regularly and has its place at professional events organized by the Pulmonary Clinic. Thanks to the offered group psychotherapy treatment, a group of the first members was created, to which others are gradually joining. It is obvious that there is great interest in this activity-it offers the possibility of sharing, a sense of belonging, and provides new information. Due to its formal involvement in ČOPN (Czech Civic Association against Lung Diseases), of which it became a member, it also influences health insurance companies.