Knoop Hans, Stulemeijer Maja, Prins Judith B, van der Meer Jos W M, Bleijenberg Gijs
Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, Post Box 9011, 6525 EC Nijmegen, The Netherlands.
Behav Res Ther. 2007 Sep;45(9):2034-43. doi: 10.1016/j.brat.2007.03.002. Epub 2007 Mar 14.
Patients with chronic fatigue syndrome (CFS) frequently report chronic pain symptoms. Cognitive behavioural therapy (CBT) for CFS results in a reduction of fatigue, but is not aimed at pain symptoms. In this study, we tested the hypothesis that a successful treatment of CFS can also lead to a reduction of pain. The second objective was to explore possible mechanisms of changes in pain. The third objective was to assess the predictive value of pain for treatment outcome. Data from two previous CBT studies were used, one of adult CFS patients (n=96) and one of adolescent CFS patients (n=32). Pain severity was assessed with a daily self-observation list at baseline and post-treatment. The location of pain in adults was assessed with the McGill Pain Questionnaire (MPQ). Patients were divided into recovered and non-recovered groups. Recovery was defined as reaching a post-treatment level of fatigue within normal range. Recovered adult and adolescent CFS patients reported a significant reduction of pain severity compared to non-recovered patients. Recovered adult patients also had fewer pain locations following treatment. The decrease in fatigue predicted the change in pain severity. In adult patients, a higher pain severity at baseline was associated with a negative treatment outcome.
慢性疲劳综合征（CFS）患者经常报告有慢性疼痛症状。针对CFS的认知行为疗法（CBT）可减轻疲劳，但并非针对疼痛症状。在本研究中，我们检验了这样一个假设，即成功治疗CFS也可减轻疼痛。第二个目标是探索疼痛变化的可能机制。第三个目标是评估疼痛对治疗结果的预测价值。我们使用了之前两项CBT研究的数据，一项是关于成年CFS患者（n = 96），另一项是关于青少年CFS患者（n = 32）。在基线和治疗后，通过每日自我观察清单评估疼痛严重程度。使用麦吉尔疼痛问卷（MPQ）评估成年患者的疼痛部位。患者被分为康复组和未康复组。康复定义为治疗后疲劳水平达到正常范围。与未康复患者相比，康复的成年和青少年CFS患者报告疼痛严重程度显著降低。康复的成年患者治疗后疼痛部位也较少。疲劳的减轻预示着疼痛严重程度的变化。在成年患者中，基线时较高的疼痛严重程度与负面治疗结果相关。
