Department of Psychological Medicine, Institute of Psychiatry, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK.
Behav Res Ther. 2012 Nov;50(11):719-25. doi: 10.1016/j.brat.2012.08.005. Epub 2012 Aug 31.
The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with deterioration in these outcomes between six and 24-month follow-up.
本研究旨在探讨以家庭为中心的认知行为疗法（CBT）与心理教育相比，在提高慢性疲劳综合征（CFS）青少年的就学率和其他次要结局方面的长期疗效。对一项随机对照试验进行了 24 个月的随访。参与者接受了 13 次 1 小时的以家庭为中心的 CBT 或 4 次 1 小时的心理教育。44 名参与者参加了随访研究。在 24 个月时，报告至少 70%上学率（主要结局）的参与者比例在 CBT 组为 90%，在心理教育组为 84%；两组间差异无统计学意义（OR=1.29，p=0.80）。根据包括疲劳和上学率的定义，以家庭为中心的 CBT 组中恢复的青少年比例为 79%，而心理教育组为 64%。这种差异无统计学意义（Fisher 确切检验，p=0.34）。与心理教育相比，以家庭为中心的 CBT 在 24 个月随访时与青少年和家长报告的情绪和行为调整明显更好相关（F=6.49，p=0.02）和（F=4.52，P=0.04）。在 6 至 24 个月的随访期间，两组的损伤均显著减少，在此期间，两组在改善方面无显著差异。在 6 个月随访时观察到的其他次要结局的改善在 24 个月随访时保持不变，没有进一步的显著改善或改善方面的组间差异。总之，接受以家庭为中心的 CBT 和心理教育的 CFS 青少年取得的收益通常在两年随访时持续或保持。例外的是，以家庭为中心的 CBT 与情绪和行为困难的持续改善相关，而心理教育与这些结果在 6 至 24 个月随访期间的恶化相关。
