Stubhaug Bjarte, Lier Haldis O, Aßmus Jörg, Rongve Arvid, Kvale Gerd
Department of Research and Innovation, Fonna Hospital Trust, Haugesund, Norway.
Department of Clinical Medicine (K1), Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
Front Psychiatry. 2018 Dec 20;9:720. doi: 10.3389/fpsyt.2018.00720. eCollection 2018.
Chronic Fatigue Syndrome/Myalgic Encephalopathy (CFS/ME) is an incapacitating illness in which single treatment interventions seem to have variable effects. Based on an earlier study we have conducted a new study with a concentrated intervention program. The aims of this study were to: (1) explore the clinical course for patients with CFS/ME who participated in a treatment program delivered during four consecutive days, and (2) evaluate their satisfaction with this program. 305 patients diagnosed with CFS/ME (Oxford criteria), recruited from a clinical population referred to a specialist outpatient clinic, participated in an open uncontrolled study of the clinical course through 1 year. The study group participated in a 4-day group intervention program, comprised by education, cognitive group therapy sessions, mindfulness sessions, physical activity and writing sessions, within a context of cognitive behavioral therapy, mindfulness, acceptance and commitment model. Assessments were done by self-reports prior to the first consultation, 1 week before and 1 week after the intervention program, and at 3 months and 1 year after the intervention. SPSS 23 and R 3.3 were used for statistical analyses. The associations between case definitions and the outcome measures (Chalder Fatigue Scale (FS), Short Form 36 (SF-36) physical functioning scale) were assessed by a linear mixed effects model (LME). Results showed statistically significant clinical changes for 80% of the patients after the intervention, changes being sustained through 1 year after the program. For both Fatigue Scale (FS) and the SF-36 there were statistically significant effects of time from baseline to all time points with a statistically significant drop in scores, applying the linear mixed effects model. A subgroup fulfilling the inclusion criteria from the PACE study (Chalder Fatigue Scale >6/11, SF-36 Physical functioning <65/100) showed clinically significant improvement through 1 year, changes in outcome measures were statistically significant ( < 0.001). None of the patients included in the program dropped out, and a great majority of patients expressed high satisfaction with the content, focus and amount of treatment. Clinical changes observed from pre-treatment to 1 year follow-up could represent effects of the 4-day concentrated intervention program, and should be further explored in a controlled study.
慢性疲劳综合征/肌痛性脑脊髓炎（CFS/ME）是一种使人丧失能力的疾病，单一治疗干预措施似乎效果各异。基于一项早期研究，我们开展了一项新的研究，采用集中干预方案。本研究的目的是：（1）探究参与连续四天治疗方案的CFS/ME患者的临床病程，以及（2）评估他们对该方案的满意度。从转诊至专科门诊的临床人群中招募的305名被诊断为CFS/ME（牛津标准）的患者，参与了一项为期1年的临床病程开放性非对照研究。研究组参与了一个为期4天的团体干预方案，该方案在认知行为疗法、正念、接纳与承诺模型的背景下，由教育、认知团体治疗课程、正念课程、体育活动和写作课程组成。评估在首次咨询前、干预方案前1周和后1周以及干预后3个月和1年通过自我报告进行。使用SPSS 23和R 3.3进行统计分析。通过线性混合效应模型（LME）评估病例定义与结局指标（查尔德疲劳量表（FS）、简短健康调查问卷36项（SF-36）身体功能量表）之间的关联。结果显示，干预后80%的患者出现了具有统计学意义的临床变化，这些变化在方案实施后持续了1年。应用线性混合效应模型，从基线到所有时间点，疲劳量表（FS）和SF-36的得分均有统计学意义的变化，且得分有统计学意义的下降。一个符合PACE研究纳入标准的亚组（查尔德疲劳量表>6/11，SF-36身体功能<65/100）在1年中显示出临床上的显著改善，结局指标的变化具有统计学意义（<0.001）。参与该方案的患者均未退出，绝大多数患者对治疗的内容、重点和量表示高度满意。从治疗前到1年随访观察到的临床变化可能代表了为期4天的集中干预方案的效果，应在对照研究中进一步探索。
