CBT/GET Assessed in Belgium

[MEKoan]

Neuro Endocrinol Lett. 2009;30(3):300-11.
Chronic fatigue syndrome: la bte noire of the Belgian health care system.

Maes M, Twisk FN.

Maes Clinics, Antwerp, Belgium. crc.mh@telenet.be

The World Health Organization acknowledges Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) to be a medical illness. ME/CFS is characterized by disorders in the inflammatory and oxidative and nitrosative stress (IO&NS) pathways. In 2002, the Belgian government started with the development of CFS "Reference Centers", which implement a "psychosocial" model. The medical practices of these CFS Centers are defined by the Superior Health Council, e.g. treatment should be based upon Cognitive Behavioral Therapy (CBT) and Graded Exercise Therapy (GET); and biological assessments and treatments of ME/CFS should not be employed. Recently, the Belgian government has evaluated the outcome of the treatments at the CFS Centers. They concluded that a "rehabilitation therapy" with CBT/GET yielded no significant efficacy in the treatment of ME/CFS and that CBT/GET cannot be considered to be curative therapies. In case reports, we have shown that patients who were "treated" at those CFS centers with CBT/GET in fact suffered from IO&NS disorders, including intracellular inflammation, an increased translocation of gram-negative enterobacteria (leaky gut), autoimmune reactions and damage by O&NS. Considering the fact that these findings are exemplary for ME/CFS patients and that GET may even be harmful, it means that many patients are maltreated by the Belgian CFS Centers. Notwithstanding the above, the government and the CFS Centers not only continue this unethical and immoral policy, but also reinforce their use of CBT/GET in patients with ME/CFS treated at those Centers.

PMID: 19855351 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/19855351?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=4&log$=relatedarticles&logdbfrom=pubmed

 

[_Kim_]

Thanks Koan

Although Tomk had posted this article, it got buried deep in The Psychiatric view of ME/CFS. What is it? thread and many may not have seen it.

Maes/Twisk - this researcher/writer duo - have a talent for publishing with the most provocative titles. I wouldn't expect anything less from the Belgians.

 

[MEKoan]

I know, the title is great, isn't it!

I did a quick scan to see if this was here but did not see it and all my brain could manage to hold, with effort, was how to copy and paste this - it was more than I could comprehend to search for it

I can't read any of this stuff without feeling profound gratitude for having been moved to Canada at age 5. Thank you, thank you parents!

 

[starryeyes]

Recently, the Belgian government has evaluated the outcome of the treatments at the CFS Centers. They concluded that a "rehabilitation therapy" with CBT/GET yielded no significant efficacy in the treatment of ME/CFS and that CBT/GET cannot be considered to be curative therapies.

Well that's good. It sounds like they're actually testing CBT and GET on real CFS patients too.

Considering the fact that these findings are exemplary for ME/CFS patients and that GET may even be harmful, it means that many patients are maltreated by the Belgian CFS Centers. Notwithstanding the above, the government and the CFS Centers not only continue this unethical and immoral policy, but also reinforce their use of CBT/GET in patients with ME/CFS treated at those Centers.

Oh bummer. Figures.

Do you meant this title: CBT/GET Assessed in Belgium?

 

[Dolphin]

Do you meant this title: CBT/GET Assessed in Belgium?

Well there was a thorough assessment/audit of the rehab clinics for CBT/GET which is available on a government website (or at least was up to recently - don't know if it's still there) so not sure the title is wrong (the report is available in French and Dutch only but some people have done summaries in English).

 

[MEKoan]

Do you meant this title: CBT/GET Assessed in Belgium?

Uhm... yes? Now I'm trying to figure out what's wrong with it The Belgians do live in Belgium, yes? Is that how you spell "assessed"? CBT? check. GET? check I'm so confused! What am I missing? Is this going to be a head slapper?

 

[starryeyes]

lol Koan! No, none of that is wrong. Ahm.. I just wanted to make sure I was seeing the same title you both thought was great. I think it's a good title too.

That's good to know, TomK, but it did PWC no good huh?

 

[Dolphin]

That's good to know, TomK, but it did PWC no good huh?

Yes. They used the Fukuda criteria which possibly helped - lots of people think the people who are improving in some UK clinics and research don't really have proper CFS (they have often used the Oxford criteria in research which just requires fatigue).

They found:
- some improvement on results on questionnaire data (more people improving but still a substantial number with worse questionnaire scores)
- little change on the exercise tests (despite people having 41/42 (can't remember which) on average!)
- people worked less hours at the end and at follow up and more people gave up work than re-started.

 

[MEKoan]

LOL Teej! I went over it and over it and over it --- usually it is a head slapper and I am astonished at what I find! And, I have brain cramp lately so it took a long, long time to figure out what to call the thread in the first place but that isn't the title that's great.

The title we thought was great was: Chronic fatigue syndrome: la bte noire of the Belgian health care system.

smiling

 

[starryeyes]

Oh! Okay I did miss that title. Thank you and yes that is a great title.

 

[Frank]

Belgium may have top researchers like De Meirleir and Maes, but apart from those two CBT/GET is the only way to go, and the only thing that's covered over here. I have heard that 2010 will be the year that the government will push CBT/GET. Big time miserie.. :-(. My hopes lay somewhere in the US.