Hostname: page-component-7c8c6479df-hgkh8 Total loading time: 0 Render date: 2024-03-28T04:15:49.028Z Has data issue: false hasContentIssue false

Guided Self-Help for Patients with Chronic Fatigue Syndrome Prior to Starting Cognitive Behavioural Therapy: a Cohort Study

Published online by Cambridge University Press:  05 May 2017

Sheila Ali
Affiliation:
Chronic Fatigue Research and Treatment Unit, South London and Maudsley NHS Foundation Trust, UK
Kimberley Goldsmith
Affiliation:
Biostatistics & Health Informatics Department, Division of Psychology and Systems Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
Mary Burgess
Affiliation:
Chronic Fatigue Research and Treatment Unit, South London and Maudsley NHS Foundation Trust, UK
Trudie Chalder*
Affiliation:
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
*
*Correspondence to Professor Trudie Chalder, Department of Psychological Medicine, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK. E-mail address: trudie.chalder@kcl.ac.uk

Abstract

Background: Previous research suggests that minimal interventions such as self-help guidance can improve outcomes in patients with fatigue or chronic fatigue syndrome (CFS). Aims: The aim of the current study was to investigate whether self-help guidance could improve physical functioning, social adjustment and fatigue in a group of patients with CFS who were awaiting CBT at a clinic in secondary care. Method: Patients completed questionnaires at their initial assessment (baseline), immediately before beginning CBT (pre-treatment), and after their last session of CBT (end of treatment). The primary outcome was physical functioning, and the secondary outcomes were social adjustment and fatigue. Multi-level linear models were used to assess change over time after adjustment for gender and age. Results: Multi-level models revealed that from baseline to pre-treatment, patients showed statistically significant improvements in physical functioning, but there were no statistically significant improvements in fatigue or social adjustment. However, all the primary and secondary outcomes showed statistically significant changes after CBT. Conclusions: The findings of this study indicate that self-help guidance may be beneficial for patients with CFS who are awaiting CBT treatment or those who are unable to access specialist treatment in their local area.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bower, P. and Gilbody, S. (2005). Stepped care in psychological therapies: access, effectiveness and efficiency. Narrative literature review. British Journal of Psychiatry, 186, 1117.Google Scholar
Burgess, M., Andiappan, M. and Chalder, T. (2012). Cognitive behaviour therapy for chronic fatigue syndrome in adults: face to face versus telephone treatment – a randomized controlled trial. Behavioural and Cognitive Psychotherapy, 40, 175191.CrossRefGoogle ScholarPubMed
Carpenter, J. R. and Kenward, M. G. (2008). Missing data in randomised controlled trials – a practical guide. Publication RM03/JH17/MK. Birmingham: National Institute for Health Research. Retrieved from: http://www.missingdata.org.uk Google Scholar
Castell, B. D., Kazantzis, N. and Moss-Morris, R. E. (2011). Cognitive behavioral therapy and graded exercise for chronic fatigue syndrome: a meta-analysis. Clinical Psychology: Science and Practice, 18, 311324.Google Scholar
Cella, M. and Chalder, T. (2010). Measuring fatigue in clinical and community settings. Journal of Psychosomatic Research, 69, 1722.Google Scholar
Cella, M., Chalder, T. and White, P. D. (2011). Does the heterogeneity of chronic fatigue syndrome moderate the response to cognitive behaviour therapy? An exploratory study. Psychotherapy and Psychosomatics, 80, 353358.Google Scholar
Cella, M., Sharpe, M. and Chalder, T. (2011). Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale. Journal of Psychosomatic Research, 71, 124128.CrossRefGoogle ScholarPubMed
Chalder, T. (1995). Coping with Chronic Fatigue. London: Sheldon Press.Google Scholar
Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S., Wright, D. and Wallace, E. P. (1993). Development of a fatigue scale. Journal of Psychosomatic Research, 37, 147153.Google Scholar
Chalder, T., Godfrey, E., Ridsdale, L., King, M. and Wessely, S. (2003). Predictors of outcome in a fatigued population in primary care following a randomized controlled trial. Psychological Medicine, 33, 283287.Google Scholar
Chalder, T., Wallace, P. and Wessely, S. (1997). Self-help treatment of chronic fatigue in the community: a randomized controlled trial. British Journal of Health Psychology, 2, 189197.Google Scholar
Chambers, D., Bagnall, A. M., Hempel, S. and Forbes, C. (2006). Interventions for the treatment, management and rehabilitation of patients with chronic fatigue syndrome/myalgic encephalomyelitis: an upated systematic review. Journal of the Royal Society of Medicine, 99, 506520.Google Scholar
Collin, S., Sterne, J., Hollingworth, W., May, M. and Crawley, E. (2012). Equity of access to specialist chronic fatigue syndrome (CFS/ME) services in England (2008–2010): a national survey and cross-sectional study. BMJ Open 0: e001417.CrossRefGoogle Scholar
Darbishire, L., Seed, P. and Ridsdale, L. (2005). Predictors of outcome following treatment for chronic fatigue. British Journal of Psychiatry,186, 350351.CrossRefGoogle ScholarPubMed
Edmonds, M., McGuire, H. and Price, J. (2004). Exercise therapy for chronic fatigue syndrome. Cochrane Database of Systematic Reviews, 3, 128.Google Scholar
Engels, J. M. and Diehr, P. (2003). Imputation of missing longitudinal data: a comparison of methods. Journal of Clinical Epidemiology, 56, 968976.CrossRefGoogle Scholar
Flo, E. and Chalder, T. (2014). Prevalence and predictors of recovery from chronic fatigue syndrome in a routine clinical practice. Behaviour Research and Therapy, 63, 18.Google Scholar
Friedberg, F., Napoli, A., Coronel, J., Adamowicz, J., Seva, V., Caikauskaite, I. et al. (2013). Chronic fatigue self-management in primary care: a randomized trial. Psychosomatic Medicine, 75, 650657.Google Scholar
Friedberg, F., Ngan, M. C. and Chang, J. (2014). Feasibility of a home-based self-management program for chronic fatigue. Fatigue: Biomedicine, Health and Behavior, 2, 110118.Google Scholar
Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G. and Komaroff, A. (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. Annals of Internal Medicine, 121, 953959.Google Scholar
Gega, L., Smith, J. and Reynolds, S. (2013). Cognitive behaviour therapy (CBT) for depression by computer vs. therapist: patient experiences and therapeutic processes. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 23, 218231.Google Scholar
Hardt, J., Buchwald, D., Wilks, D., Sharpe, M., Nix, W. A. and Egle, U. T. (2001). Health-related quality of life in patients with chronic fatigue syndrome: an international study. Journal of Psychosomatic Research, 51, 431434.Google Scholar
Heins, M. J., Knoop, H. and Bleijenberg, G. (2013). The role of the therapeutic relationship in cognitive behaviour therapy for chronic fatigue syndrome. Behaviour Research and Therapy, 51, 368376.Google Scholar
Corporation, IBM (2012). IBM SPSS Statistics for Windows (version 21.0). Armonk, NY: IBM Corporation.Google Scholar
Janse, A., Wiborg, J. F., Bleijenberg, G., Tummers, M. and Knoop, H. (2016). The efficacy of guided self-instruction for patients with idiopathic chronic fatigue: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 84, 377388.Google Scholar
Jason, L. A., Richman, J. A., Rademaker, A. W., Jordan, K. M., Plioplys, A. V., Taylor, R. R. et al. (1999). A community-based study of chronic fatigue syndrome. Archives of Internal Medicine, 159, 21292137.Google Scholar
Jorgensen, R. (2008). Chronic fatigue: an evolutionary concept analysis. Journal of Advanced Nursing, 63, 199207.CrossRefGoogle ScholarPubMed
Knoop, H., Van Der Meer, J. W. and Bleijenberg, G. (2008). Guided self-instructions for people with chronic fatigue syndrome: randomised controlled trial. British Journal of Psychiatry, 193, 340341.Google Scholar
Kroenke, K., Wood, D., Mangelsdorff, A., Meier, N. and Powell, J. (1988). Chronic fatigue in primary care: prevalence, patient characteristics, and outcome. Journal of the American Medical Association, 260, 929934.CrossRefGoogle ScholarPubMed
Larun, L., Brurberg, K. G., Odgaard-Jensen, J. and Price, J. R. (2016). Exercise therapy for chronic fatigue syndrome. Cochrane Database of Systematic Reviews, 2, CD003200. doi: 10.1002/14651858.CD003200.pub3 Google Scholar
Lewis, G. and Wessely, S. (1992). The epidemiology of fatigue: more questions than answers. Journal of Epidemiology and Community Health, 46, 9297.CrossRefGoogle ScholarPubMed
Malouff, J. M., Thorsteinsson, E. B., Rooke, S. E., Bhullar, N. and Schutte, N. S. (2008). Efficacy of cognitive behavioral therapy for chronic fatigue syndrome: a meta-analysis. Clinical Psychology Review, 28, 736745.CrossRefGoogle ScholarPubMed
McCrone, P., Ridsdale, L., Darbishire, L. and Seed, P. (2004). Cost-effectiveness of cognitive behavioural therapy, graded exercise and usual care for patients with chronic fatigue in primary care. Psychological Medicine, 34, 991999.Google Scholar
McHorney, C. A., Ware, J. E. Jr and Raczek, A. E. (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 31, 247263.Google Scholar
Mundt, J. C., Marks, I. M., Shear, M. K. and Greist, J. M. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. The British Journal of Psychiatry, 180, 461464.Google Scholar
National Institute for Health and Care Excellence (NICE) (2007). Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy): Diagnosis and Management of CFS/ME in Adults and Children. London.Google Scholar
Pawlikowska, T., Chalder, T., Hirsch, S. R., Wallace, P. and Wright, D. J. M. (1994). Population based study of fatigue and psychological distress. British Medical Journal, 308,763766.Google Scholar
Quarmby, L., Rimes, K. A., Deale, A., Wessely, S. and Chalder, T. (2007). Cognitive-behaviour therapy for chronic fatigue syndrome: comparison of outcomes within and outside the confines of a randomised controlled trial. Behaviour Research and Therapy, 45, 10851094.Google Scholar
Ridsdale, L., Darbishire, L. and Seed, P. T. (2004). Is graded exercise better than cognitive behaviour therapy for fatigue? A UK randomized trial in primary care. Psychological Medicine, 34, 3749.Google Scholar
Ridsdale, L., Godfrey, E., Chalder, T., Seed, P., King, M., Wallace, P. et al.; Fatigue Trialists Group (2001). Chronic fatigue in general practice. Is counselling as good as cognitive behaviour therapy? A UK randomised trial. British Journal of General Practice, 51, 1924.Google Scholar
Sharpe, M. C., Archard, L. C., Banatvala, J. E., Borysiewicz, L. K., Clare, A. W., David, A. et al. (1991). A report – chronic fatigue syndrome: guidelines for research. Journal of the Royal Society of Medicine, 84, 118121.Google Scholar
Stahl, D., Rimes, K. A. and Chalder, T. (2014). Mechanisms of change underlying the efficacy of cognitive behaviour therapy for chronic fatigue syndrome in a specialist clinic: a mediation analysis. Psychological Medicine, 44, 13311344.Google Scholar
Tummers, M., Knoop, H. and Bleijenberg, G. (2010). Effectiveness of stepped care for chronic fatigue syndrome: a randomized non-inferiority trial. Journal of Consulting and Clinical Psychology, 78, 724731.Google Scholar
Tummers, M., Knoop, H., Van Dam, A. and Bleijenberg, G. (2012). Implementing a minimal intervention for chronic fatigue syndrome in a mental health centre: a randomized controlled trial. Psychological Medicine, 42, 22052215.CrossRefGoogle Scholar
Tummers, M., Knoop, H., Van Dam, A. and Bleijenberg, G. (2013). Moderators of the treatment response to guided self-instruction for chronic fatigue syndrome. Journal of Psychosomatic Research, 74, 373377.CrossRefGoogle ScholarPubMed
Vos Vromans, D. C., Huijnen, I. P., Rijnders, L. J., Winkens, B., Knottnerus, J. A. and Smeets, R. J. (2016). Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS. Journal of Psychosomatic Research, 83, 4045.Google Scholar
Ware, J. E. Jr and Sherbourne, C. D. (1992). The MOS 36-item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473483.Google Scholar
Wessely, S., Chalder, T., Hirsch, S., Wallace, P. and Wright, D. (1997). The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome: a prospective primary care study. American Journal of Public Health, 87, 14491455.Google Scholar
White, P., Goldsmith, K., Johnson, A., Potts, L., Walwyn, R., DeCesare, J.C. et al. (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet, 377, 823836.CrossRefGoogle Scholar
Supplementary material: File

Ali supplementary material

Ali supplementary material 1

Download Ali supplementary material(File)
File 26.2 KB
Submit a response

Comments

No Comments have been published for this article.