Stulemeijer Maja, de Jong Lieke W A M, Fiselier Theo J W, Hoogveld Sigrid W B, Bleijenberg Gijs
Expert Centre Chronic Fatigue, University Medical Centre Nijmegen, PO Box 9101, 6500 HB, Netherlands.
BMJ. 2005 Jan 1;330(7481):14. doi: 10.1136/bmj.38301.587106.63. Epub 2004 Dec 7.
To evaluate the efficacy of cognitive behaviour therapy for adolescents aged 10-17 years with chronic fatigue syndrome.
Randomised controlled trial.
Department of child psychology.
71 consecutively referred patients with chronic fatigue syndrome; 36 were randomly assigned to immediate cognitive behaviour therapy and 35 to the waiting list for therapy.
10 sessions of therapy over five months. Treatment protocols depended on the type of activity pattern (relatively active or passive). All participants were assessed again after five months.
Fatigue severity (checklist individual strength), functional impairment (SF-36 physical functioning), and school attendance.
62 patients had complete data at five months (29 in the immediate therapy group and 33 on the waiting list). Patients in the therapy group reported significantly greater decrease in fatigue severity (difference in decrease on checklist individual strength was 14.5, 95% confidence interval 7.4 to 21.6) and functional impairment (difference in increase on SF-36 physical functioning was 17.3, 6.2 to 28.4) and their attendance at school increased significantly (difference in increase in percentage school attendance was 18.2, 0.8 to 35.5). They also reported a significant reduction in several accompanying symptoms. Self reported improvement was largest in the therapy group.
Cognitive behaviour therapy is an effective treatment for chronic fatigue syndrome in adolescents.
评估认知行为疗法对10至17岁慢性疲劳综合征青少年的疗效。
随机对照试验。
儿童心理学系。
71名连续转诊的慢性疲劳综合征患者;36名被随机分配接受即时认知行为疗法,35名被列入治疗等候名单。
在五个月内进行10次治疗。治疗方案取决于活动模式类型(相对活跃或被动)。五个月后对所有参与者再次进行评估。
疲劳严重程度(个人力量清单)、功能损害(SF-36身体功能)和上学出勤率。
62名患者在五个月时有完整数据(即时治疗组29名,等候名单组33名)。治疗组患者报告疲劳严重程度显著降低(个人力量清单上的降低差异为14.5,95%置信区间7.4至21.6),功能损害显著改善(SF-36身体功能的增加差异为17.3,6.2至28.4),上学出勤率显著提高(上学出勤率百分比的增加差异为18.2,0.8至35.5)。他们还报告了几种伴随症状显著减轻。自我报告的改善在治疗组中最为明显。
认知行为疗法是治疗青少年慢性疲劳综合征的有效方法。