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慢性疲劳综合征认知行为疗法后的长期随访

Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome.

作者信息

Janse Anthonie, Nikolaus Stephanie, Wiborg Jan F, Heins Marianne, van der Meer Jos W M, Bleijenberg Gijs, Tummers Marcia, Twisk Jos, Knoop Hans

机构信息

Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands; Academic Medical Center (AMC), University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam, The Netherlands.

Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands.

出版信息

J Psychosom Res. 2017 Jun;97:45-51. doi: 10.1016/j.jpsychores.2017.03.016. Epub 2017 Mar 27.

Abstract

OBJECTIVE

Cognitive behaviour therapy (CBT) is an effective treatment for chronic fatigue syndrome (CFS). Main aim was to determine whether treatment effects were maintained up to 10years after treatment.

METHODS

Participants (n=583) of previously published studies on the effects of CBT for CFS were contacted for a long-term follow-up assessment. They completed questionnaires on main outcomes fatigue severity (CIS) and physical functioning (SF-36). The course of these outcomes since post-treatment assessment was examined using mixed model analyses.

RESULTS

Between 21 and 125months after finishing CBT, 511 persons (response rate 88%) completed a follow-up assessment. At follow-up, mean fatigue severity was significantly increased to 37.60 (SD=12.76) and mean physical functioning significantly decreased to 73.16 (SD=23.56) compared to post-treatment assessment. At follow-up still 37% of the participants had fatigue scores in the normal range and 70% were not impaired in physical functioning.

CONCLUSION

Positive effects of CBT for CFS on fatigue and physical functioning were partly sustained at long-term follow-up. However, a subgroup of patients once again reported severe fatigue, and compromised physical functioning. Further research should elucidate the reasons for this deterioration to facilitate the development of treatment strategies for relapse prevention.

摘要

目的

认知行为疗法(CBT)是治疗慢性疲劳综合征(CFS)的一种有效方法。主要目的是确定治疗效果在治疗后长达10年是否能得以维持。

方法

联系了先前发表的关于CBT治疗CFS效果研究的参与者(n = 583)进行长期随访评估。他们完成了关于主要结局疲劳严重程度(CIS)和身体功能(SF - 36)的问卷调查。使用混合模型分析检查自治疗后评估以来这些结局的变化过程。

结果

在完成CBT后的21至125个月期间,511人(应答率88%)完成了随访评估。与治疗后评估相比,随访时平均疲劳严重程度显著增加至37.60(标准差 = 12.76),平均身体功能显著下降至73.16(标准差 = 23.56)。随访时仍有37%的参与者疲劳评分在正常范围内,70%的参与者身体功能未受损。

结论

CBT治疗CFS对疲劳和身体功能的积极效果在长期随访中部分得以维持。然而,有一小部分患者再次报告了严重疲劳和身体功能受损。进一步的研究应阐明这种恶化的原因,以促进预防复发治疗策略的制定。

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