Gotaas Merethe Eide, Stiles Tore C, Bjørngaard Johan Håkon, Borchgrevink Petter C, Fors Egil A
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
National Competence Centre for Complex Symptom Disorders, St. Olav's University Hospital, Trondheim, Norway.
Front Psychiatry. 2021 Apr 12;12:580924. doi: 10.3389/fpsyt.2021.580924. eCollection 2021.
To study whether standard cognitive behavioral therapy (CBT) and a shorter, interpersonal oriented cognitive behavioral therapy (I-CBT) can improve physical function and fatigue in patients diagnosed with mild to moderate chronic fatigue syndrome (CFS) in a multidisciplinary fatigue clinic. Consecutively 236 participants 18-62 years old meeting the Centre of Decease Control, CDC 1994 criteria, with a subsample also fulfilling the Canadian criteria for CFS, were randomly allocated to one of three groups. Two intervention groups received either 16 weeks of standard CBT or 8 weeks of I-CBT vs. a waiting-list control group (WLC). Primary outcome was the subscale Physical Function (PF) from SF-36 (0-100). Secondary outcome was amongst others fatigue measured by Chalder Fatigue Questionnaire (CFQ) (0-33). Outcomes were repeatedly measured up to 52 weeks from baseline. The additional effect relative to baseline at post-intervention for SF-36 physical function was 14.2 (95% CI 7.9-20.4 < 0.001) points higher for standard CBT and 6.8 (0.5-13.2 = 0.036) points higher for I-CBT compared with the control group. The additional effect relative to baseline at post-intervention for fatigue was 5.9 (95% CI 0.5-10.5 = 0.03) points lower for standard CBT compared with the control group but did not differ substantially for I-CBT 4.8 (95% CI -0.4 to 9.9 = 0.07). The positive change in physical function persisted at 1-year follow-up for both treatment groups, and for standard CBT also in fatigue. The two intervention groups did not differ significantly in self-reported physical function and fatigue at the 1-year follow-up. No serious adverse reactions were recorded in any of the groups during the trial period. A 16-week standard, individual CBT intervention improves physical function and fatigue in CFS outpatients with mild to moderate disease. A shorter 8-week I-CBT program improves physical function. Both treatments are safe, and the effect persist 1 year after baseline. ClinicalTrials.gov, Identifier: NCT00920777, registered June 15, 2009. REK-project number: 4.2008.2586, registered April 2, 2008. Funding: The Liaison Committee for Education, Research and Innovation in Central Norway.
为研究标准认知行为疗法（CBT）和一种更简短的、以人际关系为导向的认知行为疗法（I-CBT）能否改善多学科疲劳诊所中被诊断为轻至中度慢性疲劳综合征（CFS）患者的身体功能和疲劳状况。连续纳入236名年龄在18至62岁、符合疾病控制中心（CDC）1994年标准的参与者，其中一个子样本也符合加拿大CFS标准，这些参与者被随机分配到三个组中的一组。两个干预组分别接受16周的标准CBT或8周的I-CBT，与之对比的是一个等待名单对照组（WLC）。主要结局是SF-36量表中的身体功能（PF）子量表（0至100分）。次要结局包括用查尔德疲劳问卷（CFQ）（0至33分）测量的疲劳等。从基线开始直至52周，对结局进行重复测量。与对照组相比，干预后SF-36身体功能相对于基线的额外效应在标准CBT组高14.2（95%可信区间7.9至20.4，P<0.001）分，在I-CBT组高6.8（0.5至13.2，P = 0.036）分。与对照组相比，干预后疲劳相对于基线的额外效应在标准CBT组低5.9（95%可信区间0.5至10.5，P = 0.03）分，但I-CBT组差异不大，为4.8（95%可信区间-0.4至9.9，P = 0.07）分。两个治疗组在1年随访时身体功能的积极变化均持续存在，标准CBT组在疲劳方面也是如此。在1年随访时，两个干预组在自我报告的身体功能和疲劳方面无显著差异。在试验期间，任何组均未记录到严重不良反应。一项为期16周的标准个体CBT干预可改善轻至中度疾病的CFS门诊患者的身体功能和疲劳状况。一个为期8周的更简短的I-CBT方案可改善身体功能。两种治疗均安全，且效应在基线后持续1年。ClinicalTrials.gov标识符：NCT00920777，于2009年6月15日注册。REK项目编号：4.2008.2586，于2008年4月2日注册。资助：挪威中部教育、研究与创新联络委员会。
