University of Bath, Department of Psychology, Claverton Down, Bath, UK.
Clin Psychol Psychother. 2013 Mar-Apr;20(2):107-17. doi: 10.1002/cpp.793. Epub 2011 Oct 9.
Cognitive behaviour therapy (CBT) is an effective treatment for chronic fatigue syndrome (CFS; sometimes known as myalgic encephalomyelitis). However, only a minority of patients fully recover after CBT; thus, methods for improving treatment outcomes are required. This pilot study concerned a mindfulness-based cognitive therapy (MBCT) intervention adapted for people with CFS who were still experiencing excessive fatigue after CBT. The study aimed to investigate the acceptability of this new intervention and the feasibility of conducting a larger-scale randomized trial in the future. Preliminary efficacy analyses were also undertaken. Participants were randomly allocated to MBCT or waiting list. Sixteen MBCT participants and 19 waiting-list participants completed the study, with the intervention being delivered in two separate groups. Acceptability, engagement and participant-rated helpfulness of the intervention were high. Analysis of covariance controlling for pre-treatment scores indicated that, at post-treatment, MBCT participants reported lower levels of fatigue (the primary clinical outcome) than the waiting-list group. Similarly, there were significant group differences in fatigue at 2-month follow-up, and when the MBCT group was followed up to 6 months post-treatment, these improvements were maintained. The MBCT group also had superior outcomes on measures of impairment, depressed mood, catastrophic thinking about fatigue, all-or-nothing behavioural responses, unhelpful beliefs about emotions, mindfulness and self-compassion. In conclusion, MBCT is a promising and acceptable additional intervention for people still experiencing excessive fatigue after CBT for CFS, which should be investigated in a larger randomized controlled trial.
Only about 30% of people with chronic fatigue syndrome (CFS) recover after cognitive behaviour therapy (CBT); thus, methods for improving treatment outcomes are needed. This is the first pilot randomized study to demonstrate that a mindfulness-based intervention was associated with reduced fatigue and other benefits for people with CFS who were still experiencing excessive fatigue after a course of CBT. Levels of acceptability, engagement in the intervention and rated helpfulness were high. A larger-scale randomized controlled trial is required.
背景：认知行为疗法（CBT）是慢性疲劳综合征（CFS；有时也称为肌痛性脑脊髓炎）的有效治疗方法。然而，只有少数患者在接受 CBT 后完全康复；因此，需要寻找改善治疗效果的方法。本研究是一项关于正念认知疗法（MBCT）的试点研究，该研究针对的是在接受 CBT 后仍有过度疲劳症状的 CFS 患者。该研究旨在探讨这种新干预措施的可接受性，并为今后开展更大规模的随机试验提供可行性。初步疗效分析也同时进行。
方法：参与者被随机分配到 MBCT 组或等待名单组。共有 16 名 MBCT 组参与者和 19 名等待名单组参与者完成了研究，干预措施分两组进行。
结果：接受度、参与度和参与者对干预措施的评价都很高。协方差分析表明，治疗后 MBCT 组的疲劳水平（主要的临床结局）低于等待名单组。同样，在 2 个月的随访中，两组间存在显著差异，当 MBCT 组在治疗后 6 个月进行随访时，这些改善仍然存在。MBCT 组在疲劳、抑郁情绪、对疲劳的灾难性思维、全或无行为反应、对情绪的无益信念、正念和自我同情方面的测量结果也更优。
结论：MBCT 是一种有前途且可接受的额外干预措施，可用于在接受 CBT 治疗后仍有过度疲劳的 CFS 患者，应该在更大的随机对照试验中进行研究。
要点：慢性疲劳综合征（CFS）患者接受认知行为疗法（CBT）后，约有 30%的人能完全康复，因此需要寻找提高治疗效果的方法。这是第一项表明正念干预与接受过 CBT 治疗后仍有过度疲劳的 CFS 患者的疲劳减轻和其他益处相关的试点随机研究。接受度、参与度和评价有用性均较高。需要进行更大规模的随机对照试验。
