The Placebo Response in the Treatment of Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis

Cho, Hyong Jin; Hotopf, Matthew; Wessely, Simon

doi:10.1097/01.psy.0000156969.76986.e0

Cited by 96 publications

(63 citation statements)

References 81 publications

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“…Cho et al's systematic review [25] concludes that placebo effects are substantially diminished in patients with CFS. However, many people entering this study were already using CAM so any benefits that may be observed from either CAM medications or the nonspecific effects of seeing a CAM practitioner are likely to have already been apparent prior to entry into the trial.…”

Section: Discussionmentioning

confidence: 99%

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome

Lewith

Stuart

Chalder

et al. 2016

Journal of Psychosomatic Research

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Section: Discussionmentioning

confidence: 99%

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome

Lewith

Stuart

Chalder

et al. 2016

Journal of Psychosomatic Research

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“…For example, we could not find a doseresponse effect for CBT. Furthermore, no effect of an attention placebo group on fatigue was found in patients with chronic fatigue syndrome (CFS) [40,41].…”

Section: Discussionmentioning

confidence: 99%

Is Increasing Physical Activity Necessary to Diminish Fatigue During Cancer Treatment? Comparing Cognitive Behavior Therapy and a Brief Nursing Intervention with Usual Care in a Multicenter Randomized Controlled Trial

Goedendorp¹,

Peters²,

Gielissen³

et al. 2010

The Oncologist

111

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Background. Two interventions for fatigue were given during curative cancer treatment. The aim of this multicenter randomized controlled trial (RCT) with three conditions was to demonstrate the efficacy and to determine the contribution of physical activity.Methods. Recruited from seven hospitals, 220 patients with various malignancies participated in a RCT. The brief nursing intervention (BNI) consisted of two 1-hour sessions, 3 months apart, given by 12 trained nurses, focusing only on physical activity. Cognitive behavior therapy (CBT) consisted of up to ten 1-hour sessions, within 6 months, provided by two therapists, focusing on physical activity and psychosocial elements. The control group received only usual care (UC). Assessments took place before and at least 2 months after cancer treatment, when patients had recovered from acute fatigue. Fatigue was the

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“…11 However, oral iron administration has limitations: it is often accompanied by gastrointestinal side effects and only ϳ 10% of orally administered iron is absorbed by the body. 6 Investigation of any therapeutic approach to reducing fatigue can be influenced by a strong placebo effect, 19 making a placebocontrolled and blinded study design essential for drawing conclusions relevant for medical practice. Prior studies analyzing the effect of iron supplementation on fatigue improvement were performed with oral iron, which can result in an unintended unblinding of patients because of intestinal side effects and stool coloring and thus influence study results.…”

Section: Introductionmentioning

confidence: 99%

Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration

Krayenbuehl

Battegay

Breymann

et al. 2011

Blood

224

197

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This is the first study to investigate the efficacy of intravenous iron in treating fatigue in nonanemic patients with low serum ferritin concentration. In a randomized, double-blinded, placebo-controlled study, 90 premenopausal women presenting with fatigue, serum ferritin < 50 ng/mL, and hemoglobin > 120 g/L were randomized to receive either 800 mg of intravenous iron (III)-hydroxide sucrose or intravenous placebo. Fatigue and serum iron status were assessed at baseline and after 6 and 12 weeks. Median fatigue at baseline was 4.5 (on a 0-10 scale). Fatigue decreased during the initial 6 weeks by 1.1 in the iron group compared with 0.7 in the placebo group (P ‫؍‬ .07). Efficacy of iron was bound to depleted iron stores: In patients with baseline serum ferritin < 15 ng/mL, fatigue decreased by 1.8 in the iron group compared with 0.4 in the placebo group (P ‫؍‬ .005), and 82% of iron-treated compared with 47% of placebo-treated patients reported improved fatigue (P ‫؍‬ .03). Drug-associated adverse events were observed in 21% of iron-treated patients and in 7% of placebo-treated patients (P ‫؍‬ .05); none of these events was serious. Intravenous administration of iron improved fatigue in iron-deficient, nonanemic women with a good safety and tolerability profile. The efficacy of intravenous iron was bound to a serum ferritin concentration < 15 ng/mL. Continuing Medical Education onlineThis activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and the American Society of Hematology. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians. Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at http://www.medscape.org/journal/blood; and (4) view/print certificate. For CME questions, see page 3450. Disclosures This study was funded by Vifor Pharma (Villars-sur-Glâne, Switzerland). The sponsor of the study was involved in the trial design and was responsible for data collection and storage. The authors had full access to all data and were responsible for the analysis and interpretation of the data presented in this publication. Christian Breymann is a consulting expert for Vifor Pharma in the field of obstetrics and gynecology. The remaining authors, the Associate Editor Martin S. Tallman, and the CME questions author Laurie Barclay, freelance writer and reviewer, Medscape, LLC, declare no competing financial interests. Learning objectives Upon completion of th...

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The Placebo Response in the Treatment of Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis

Abstract: In contrast with the conventional wisdom, the placebo response in CFS is low. Psychological-psychiatric interventions were shown to have a lower placebo response, perhaps linked to patient expectations.

Cited by 96 publications

References 81 publications

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome

Is Increasing Physical Activity Necessary to Diminish Fatigue During Cancer Treatment? Comparing Cognitive Behavior Therapy and a Brief Nursing Intervention with Usual Care in a Multicenter Randomized Controlled Trial

Intravenous iron for the treatment of fatigue in nonanemic, premenopausal women with low serum ferritin concentration

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