Amsterdam UMC, University of Amsterdam, department of Medical Psychology, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, Netherlands.
Expert Center for Chronic Fatigue, Amsterdam UMC, VU University Amsterdam, department of Medical Psychology, De Boelelaan 1117, Amsterdam, Netherlands.
J Psychosom Res. 2020 Aug;135:110133. doi: 10.1016/j.jpsychores.2020.110133. Epub 2020 May 5.
In chronic fatigue syndrome (CFS) little is known about how partner-related factors influence patients' fatigue symptoms and treatment outcome. We examined partners' fatigue severity, and determined the role of partner-related factors for patients' symptoms and the outcome of cognitive behavioural therapy (CBT).
1356 CFS patients and their partners completed baseline measures of fatigue severity (Checklist Individual Strength), causal attributions of symptoms, partner responses to patient symptoms, and relationship satisfaction. Fatigue in partners of patients with CFS was compared with fatigue in age- and gender-matched controls from the Dutch population. Associations between partners' fatigue severity and other partner-related factors were determined. In a subgroup of 760 CFS patients who completed CBT, logistic regression analyses were used to identify partner-related baseline predictors for treatment outcome (fatigue severity, functional impairment).
Partners' fatigue (M = 21.66, SD 11.60) was significantly lower than in controls (M = 24.58, SD = 11.02) (p < .001) and not related to patients' fatigue (r = -0.02, p = .58). Partners' fatigue was correlated with patients' functional impairment (p = .001), partners' and patients' relationship dissatisfaction, negative partner responses, and partners' and patients' psychological attributions of patient symptoms at baseline (all p < .001). After controlling for patients' baseline fatigue severity and functional impairment, only relationship dissatisfaction as reported by (female) patients significantly predicted worse treatment outcome. For male patients with female partners, higher partners' fatigue severity predicted higher fatigue severity after CBT.
Female partners' fatigue and relationship dissatisfaction as reported by the female patient should be addressed in CBT for CFS, as these factors affect treatment outcome.
在慢性疲劳综合征（CFS）中，伴侣相关因素如何影响患者的疲劳症状和治疗效果知之甚少。我们研究了伴侣的疲劳严重程度，并确定了伴侣相关因素对患者症状和认知行为疗法（CBT）治疗结果的作用。
1356 名 CFS 患者及其伴侣完成了基线疲劳严重程度（个体力量检查表）、症状归因、伴侣对患者症状的反应和关系满意度的评估。将 CFS 患者伴侣的疲劳与荷兰人口中年龄和性别匹配的对照者的疲劳进行了比较。确定了伴侣疲劳严重程度与其他伴侣相关因素之间的关联。在完成 CBT 的 760 名 CFS 患者的亚组中，使用逻辑回归分析确定了治疗结果（疲劳严重程度、功能障碍）的伴侣相关基线预测因子。
伴侣的疲劳（M=21.66，SD=11.60）显著低于对照组（M=24.58，SD=11.02）（p<0.001），与患者的疲劳无关（r=-0.02，p=0.58）。伴侣的疲劳与患者的功能障碍相关（p=0.001），与患者的伴侣关系不满意、负面的伴侣反应、以及患者和伴侣对患者症状的心理归因相关（均 p<0.001）。在控制了患者的基线疲劳严重程度和功能障碍后，只有患者报告的关系不满意才显著预测了更差的治疗结果。对于女性患者的男性伴侣，伴侣的疲劳严重程度越高，CBT 后疲劳严重程度越高。
CFS 的 CBT 应针对女性患者报告的女性伴侣的疲劳和关系不满意，因为这些因素会影响治疗结果。
