Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome? Knoop

[Dolphin]

Psychother Psychosom. 2007;76(3):171-6.
Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome?
Knoop H1, Bleijenberg G, Gielissen MF, van der Meer JW, White PD.
Author information

Abstract
BACKGROUND:
Cognitive behavioural therapy (CBT) for chronic fatigue syndrome (CFS) leads to a decrease in symptoms and disabilities. There is controversy about the nature of the change following treatment; some suggest that patients improve by learning to adapt to a chroniccondition, others think that recovery is possible. The objective of this study was to find out whether recovery from CFS is possible after CBT.

METHODS:
The outcome of a cohort of 96 patients treated for CFS with CBT was studied. The definition of recovery was based on the absence of the criteria for CFS set up by the Center for Disease Control (CDC), but also took into account the perception of the patients' fatigue and their own health. Data from healthy population norms were used in calculating conservative thresholds for recovery.

RESULTS:
After treatment, 69% of the patients no longer met the CDC criteria for CFS. The percentage of recovered patients depended on the criteria used for recovery. Using the most comprehensive definition of recovery, 23% of the patients fully recovered. Fewer patients with a co-morbid medical condition recovered.

CONCLUSION:
Significant improvement following CBT is probable and a full recovery is possible. Sharing this information with patients can raise the expectations of the treatment, which may enhance outcomes without raising false hopes.

PMID: 17426416

DOI: 10.1159/000099844

 

[Dolphin]

When I initially read this I thought that the SIP8 criterion <=203 was part of the definition of full recovery. However looking back on it again I think maybe it is not included (and that if it was used the figure for full recovery might be lower).

If one looks at the group of those with comorbidities in Table 4., "No disabilities in all domains" = 9%. However, "Combining criteria of fatigue, disabilities and perception of health and fatigue" = 12%. This latter figure should really be 9% or lower if "No disabilities in all domains" is a criterion, though I suppose if there was missing data on some items, it would be possible to get an overall percentage of 12%.

If one looks at table 1, the part below the line seems to be set of criteria used for full recovery. The SIP8 part is not used there.

Similarly the text says:

Combining Fatigue, Disabilities and Perception
This comprehensive definition of recovery was operationalized by combining the cut-off scores on the CIS-fatigue, the SF-36 scales of physical functioning and social disabilities, the general health perception and the FQL.

I.e. no mention of the SIP8

 

[concepcion]

This "study" is 10 years old.

 

[Dolphin]

This "study" is 10 years old.

Yes, but the recent paper by Twisk & Corsius got me thinking about it again. I couldn't fit the year in the title.

 

[Learner1]

I'm scratching my head trying to figure out how CBT would cure infections, immune system dysfunction, nutrient and hormone deficiencies/imbalances, toxicity, and/or other problems underlying ME/CFS for many patients.

Did the patients in the study have PEM or othostatic intolerance? Were those measured as recovered, too, with CBT?

 

[Jesse2233]

23% could encompass spontaneous remission, misdiagnosis, methodalogical errors, and relapse / remitting patterns