Does the Heterogeneity of Chronic Fatigue Syndrome Moderate the Response
[Apologies - I can't change the heading - this isn't to do with PACE. If a moderator or admin could correct the subject line, it'd be great.]
Vol. 80, No. 6, 2011
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http://content.karger.com/ProdukteD...ikelNr=327582&Ausgabe=255497&ProduktNr=223864
* I've given each sentence its own paragraph
[Apologies - I can't change the heading - this isn't to do with PACE. If a moderator or admin could correct the subject line, it'd be great.]
Vol. 80, No. 6, 2011
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http://content.karger.com/ProdukteD...ikelNr=327582&Ausgabe=255497&ProduktNr=223864
Regular Article
Does the Heterogeneity of Chronic Fatigue Syndrome Moderate the Response to Cognitive Behaviour Therapy? An Exploratory Study
Matteo Cella a, b, Trudie Chalder a, Peter D. White c
aDepartment of Psychological Medicine, Institute of Psychiatry, Kings College London, bDepartment of Clinical, Educational and Health Psychology, University College London, and cCenter for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University, London, UK
Address of Corresponding Author
Psychother Psychosom 2011;80:353-358 (DOI: 10.1159/000327582)
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Key Words
Chronic fatigue syndrome
Cognitive behaviour therapy
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Abstract*
Background:
Chronic fatigue syndrome (CFS) is a heterogeneous condition.
A few studies have shown that some independent factors predict outcomes after cognitive behaviour therapy (CBT).
Two recent systematic reviews suggest that heterogeneity may moderate treatment outcomes.
However, no study has explored whether subgroups of CFS predict response to treatment.
Methods:
We used both latent class analysis (LCA) and latent class regression
(LCR) to clarify the relationship between subgroups of CFS patients (n = 236), diagnosed using the Oxford diagnostic criteria, and the response to CBT.
We measured symptoms, demographics, mood, and cognitive and behavioural responses to illness to define subgroups.
Results:
We found 5 latent classes by LCA, which did not differ in the direction of their response to CBT, with all classes showing improvement.
In contrast, an exploratory LCR identified 4 latent classes, 1 of which predicted a poor response to CBT, whereas the other 3 predicted a good outcome, accounting for more than 70% of the patients.
The negative outcome class was defined by weight fluctuations and physical shakiness, anxiety, pain and being focused on symptoms.
Conclusions:
CBT should be offered to all classes of patients with CFS, when defined by these measures.
It may be possible to predict a minority group with a negative outcome, but this exploratory work needs replication.
Copyright 2011 S. Karger AG, Basel
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Author Contacts
Matteo Cella
Kings College London, Institute of Psychiatry, Department of Psychological Medicine Weston Education Centre, Cutcombe Rd London SE5 9RJ (UK) Tel. +44 20 3228 3191, E-Mail matteo.cella@kcl.ac.uk
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Article Information
Received: November 11, 2010
Accepted after revision: March 13, 2011
Published online: August 6, 2011
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 2, Number of References : 48
* I've given each sentence its own paragraph