Fatigue In Teenagers on the interNET (CFS) (just protocol paper at the moment)

[Dolphin]

Free full text: http://www.biomedcentral.com/1471-2377/11/23

Fatigue In Teenagers on the interNET - The FITNET Trial. A randomized clinical trial of web-based cognitive behavioural therapy for adolescents with chronic fatigue syndrome: study protocol. [ISRCTN59878666].

BMC Neurol. 2011 Feb 19;11(1):23. [Epub ahead of print]

Nijhof SL, Bleijenberg G, Uiterwaal CS, Kimpen JL, van de Putte EM.

Abstract
ABSTRACT:

BACKGROUND: Chronic Fatigue Syndrome (CFS) is increasingly recognized as a cause of disability and inactivity in adolescents in the Netherlands. CFS is characterized by unexplained fatigue lasting more than 6 months. Cognitive Behavioural Therapy (CBT) has proven to be effective. However, CBT availability for adolescents with CFS is limited and requires special therapeutic skills not always readily available. An alternative to the face-to-face CBT is FITNET, a web-based therapeutic program designed specifically for adolescents diagnosed with CFS, and their parents. This new CBT approach appeals to the modern youth, who grow up with internet as their main source of information. A web-based program offers the opportunity to lower thresholds for the acceptance and realization of healthcare. This treatment can be activated at any chosen time. The communication between patient and therapist can elapse asynchronously. If effective, this web-based program would greatly increase the therapeutic accessibility.

METHODS: A randomized clinical trial is currently conducted. One-hundred-forty adolescents aged 12-18 years diagnosed with CFS will be recruited and randomized to one of two groups: FITNET or usual care. After 6 months, the usual care group will have access to the FITNET program. Outcomes will be assessed at baseline, post intervention, and at 6 months follow-up. Primary outcome measures are school presence, fatigue severity, and physical functioning.

DISCUSSION: The FITNET study is the first randomized clinical trial which evaluates the effect of web-based CBT versus usual care in adolescents with CFS. The intervention is based on a theoretical existing model of CBT for patients with CFS. The results of this study will provide information about the possibility and efficacy of web-based CBT for adolescents with CFS and will reveal predictors of efficacy.

PMID: 21333021 [PubMed - as supplied by publisher]

 

[Dolphin]

Bleijenberg and co at making questionable recovery rate claims again

Bleijenberg and co at making questionable recovery rate claims again

Cognitions concerning
these sustaining and perpetuating factors are
subject of the cognitive behavioural therapy (CBT) regimen
for adolescents. CBT is the only evidence-based
treatment with a recovery rate of 70% directly after
treatment [3]. An uncontrolled study of the efficacy of
family cognitive behaviour therapy for adolescents with
CFS, revealed even better results with a recovery rate of
83%, with a maintained gain at 6 months follow-up [4].

3. Stulemeijer M, de Jong LW, Fiselier TJ, Hoogveld SW, Bleijenberg G:
Cognitive behaviour therapy for adolescents with chronic fatigue
syndrome: randomised controlled trial. BMJ 2005, 330(7481):14.
http://www.bmj.com/content/early/2003/12/31/bmj.38301.587106.63.full.pdf

4. Chalder T, Tong J, Deary V: Family cognitive behaviour therapy for
chronic fatigue syndrome: an uncontrolled study. Arch Dis Child 2002,
86(2):95-97.

The figure referred to for [3] from what I see is:

Self rated improvement
Cognitive behaviour 25/35 (71%)
Waiting list 15/34 (44%)

Answer yes to statement I have completely recovered or I feel much better but still
experience some symptoms.

Other thresholds had percentages lower than 70/71%.

Definition for [4]

At six months follow up, 83% of patients (15/18), for whom we
had measures of school attendance and fatigue scores,
improved according to our criterion for improvement (fatigue
<4 and going to school 75% of the time).