Review articleEffectiveness of cognitive behavioral therapy for the treatment of fatigue in patients with multiple sclerosis: A systematic review and meta-analysis
Section snippets
Search methods
This meta-analysis used the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines for systematic reviews and meta-analyses [21]. The literature search concluded on February 8, 2016. The following databases were searched: Pubmed; Cochrane, EMBASE, Psychology and Behavioral Sciences Collection, ERIC, PsychINFO, Cinahl and PsycARTICLES. In addition, trial registers were searched to identify published and unpublished trials on the topic and, when necessary
Results
The initial search yielded 994 articles, of which 833 remained after removal of duplicates. Five authors of unpublished articles were contacted about the progress of their research and preliminary results, however, this did not result in extra information. In total, 734 articles were excluded based on the title and abstract. Of the remaining 99 articles, 30 were excluded because CBT was not used, 16 articles did not use fatigue as a primary outcome measure, 24 studies did not use an RCT design
Discussion
The results of this review and meta-analysis show that CBT has a positive moderate short-term effect (SMD = − 0.47; CI 95% − 0.88, − 0.06), which turns into a small long-term effect when treatment ends (SMD = − 0.30; CI 95% − 0.51, − 0.08). A note of caution is due since the way CBT was provided was quite heterogeneous in terms of the mode of delivery of CBT (e.g. internet guidance vs. phone contact; group vs. individual guidance), the intensity (i.e. number and duration of sessions) and the type of
Conclusion
The results of the current systematic review and meta-analysis suggest a moderately positive effect of CBT for the treatment of fatigue in patients with MS. However, this effect declines after cessation of treatment. Since the short-term effect of CBT on MS-related fatigue is positive, more research is needed to develop interventions that maintain these short-term effects in the long term.
Funding
The TREFAMS-ACE study is funded by the Fonds NutsOhra (ZonMw 89000005).
Acknowledgements
This study is supported by the Fonds NutsOhra (grant no. ZonMW 89000005). This article is produced in the context of the Trefams-ACE study: treatment of fatigue in multiple sclerosis: aerobic training, cognitive behavioral therapy and Energy Conservation Management.
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