Knoop Hans, Bleijenberg Gijs, Gielissen Marieke F M, van der Meer Jos W M, White Peter D
Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Psychother Psychosom. 2007;76(3):171-6. doi: 10.1159/000099844.
Cognitive behavioural therapy (CBT) for chronic fatigue syndrome (CFS) leads to a decrease in symptoms and disabilities. There is controversy about the nature of the change following treatment; some suggest that patients improve by learning to adapt to a chronic condition, others think that recovery is possible. The objective of this study was to find out whether recovery from CFS is possible after CBT.
The outcome of a cohort of 96 patients treated for CFS with CBT was studied. The definition of recovery was based on the absence of the criteria for CFS set up by the Center for Disease Control (CDC), but also took into account the perception of the patients' fatigue and their own health. Data from healthy population norms were used in calculating conservative thresholds for recovery.
After treatment, 69% of the patients no longer met the CDC criteria for CFS. The percentage of recovered patients depended on the criteria used for recovery. Using the most comprehensive definition of recovery, 23% of the patients fully recovered. Fewer patients with a co-morbid medical condition recovered.
Significant improvement following CBT is probable and a full recovery is possible. Sharing this information with patients can raise the expectations of the treatment, which may enhance outcomes without raising false hopes.
针对慢性疲劳综合征（CFS）的认知行为疗法（CBT）可减轻症状和残疾程度。关于治疗后变化的本质存在争议；一些人认为患者通过学习适应慢性病况而有所改善，另一些人则认为有可能康复。本研究的目的是查明接受CBT后CFS患者是否有可能康复。
对96例接受CBT治疗的CFS患者队列的结果进行了研究。康复的定义基于未达到疾病控制中心（CDC）制定的CFS标准，但也考虑了患者对疲劳的感受及其自身健康状况。来自健康人群规范的数据用于计算康复的保守阈值。
治疗后，69%的患者不再符合CDC的CFS标准。康复患者的百分比取决于所采用的康复标准。采用最全面的康复定义时，23%的患者完全康复。患有合并症的患者康复人数较少。
CBT治疗后显著改善是可能的，完全康复也是可能的。与患者分享这些信息可以提高他们对治疗的期望，这可能会改善治疗效果而不产生不切实际的希望。
