First Simon Wessely leaves the field (again), now the Dutch CBT & Biopsychosocial supremo will retire this Friday. I suspect there are many researchers left behind who will eagerly continue their work.
Original article in Dutch
Translation (using Google Translate & Yahoo! Babelfish), plus a bit of tidying up of the English by me (I speak no Dutch)). Corrections welcome:
"Fatigue has many faces': farewell speech of Prof. Gijs Bleijenberg
Prof. Gijs Bleijenberg, the clinical psychologist who introduced cognitive behavioral therapy for chronic fatigue syndrome, is stepping down as chair at the UMC. He is retiring. In his farewell speech, he explains why not all types of fatigue are the same. And what they have in common.
Chronic fatigue is a disaster not only for the individual, but also a major social problem. Besides the people who suffer from CFS, experts estimate around 80,000, there are also others who are dealing with extreme fatigue. For example, people who have been treated for cancer or people with chronic illness. Many chronic diseases are known to be associated with severe fatigue. According to Bleijenberg this means that in the Netherlands at least half a million people have chronic fatigue.
For most of his working life Bleijenberg has been involved with chronic fatigue and its treatment. In the Netherlands he developed a form of cognitive behavioral therapy (CBT) which is effective in people with chronic fatigue syndrome. Later it appeared that other people with chronic fatigue will benefit from this form of therapy. Together with his colleagues he developed effective forms of CBT for cancer-related fatigue, chronic fatigue in MS patients and in neuromuscular diseases.
Bleijenberg: What amazes is that there is so little money is allocated to the national introduction of these effective therapies. "There is a lot of money spent on proper investigation into the treatment of fatigue," he says in his farewell speech, "that has produced good treatment (Google translate: cures). These treatments can now be performed by trained behavioral therapists, but there is hardly any money available for their training. The additional behavioral training would be a great way to save money: it would relieve the burden of fatigue and reduce reliance on expensive equipment. "
In his farewell speech, Bleijenberg discussed the mechanism of action of CBT. This is much the same for the various groups with severe fatigue. CBT is effective because it changes the patient's attitudes and thinking about fatigue. Changes in attitudes about physical activity and exercise also have an effect on decreasing fatigue.
Graded exercise therapy (GET), based on gradually increasing physical activity, is also effective for chronic fatigue syndrome. "But here it appears the move [exercise?] itself is not the operative factor," said Bleijenberg. "Even with this therapy, the beliefs about exercise change will be effective."
However, different chronic fatigue states are not the same. The Donders found with the Nijmegen Research Centre Chronic Fatigue, that people with CFS have less gray matter in their brains than healthy people. After treatment with CBT, the volume of gray matter increases. On the other hand, in case of fatigue after cancer, there was no decrease in gray matter, and can be seen therefore, do not increase in gray matter after the treatment. This indicates that CFS is different biologically than cancer-related fatigue.
Something similar can be seen at the level of the hormone cortisol in saliva. In CFS, this content is relatively low and it increases as the cognitive-behavioral starts better. In people who have had cancer, there is no difference in cortisol levels between fatigued and non-fatigued.
The many faces of fatigue
The circumstances preceding the fatigue and the factors that maintain fatigue are differenct between patient groups. Therefore, the therapy for each patient group needs to be adjusted independently. "The many faces of fatigue" is the title of the symposium held to mark the retirement of Bleijenberg. Speakers from home and abroad discuss treatment of chronic fatigue in different groups of patients such as people with MS, COPD and heart disease.
Source: UMCStRadboud@umcn.nl
Original article in Dutch
Translation (using Google Translate & Yahoo! Babelfish), plus a bit of tidying up of the English by me (I speak no Dutch)). Corrections welcome:
"Fatigue has many faces': farewell speech of Prof. Gijs Bleijenberg
Prof. Gijs Bleijenberg, the clinical psychologist who introduced cognitive behavioral therapy for chronic fatigue syndrome, is stepping down as chair at the UMC. He is retiring. In his farewell speech, he explains why not all types of fatigue are the same. And what they have in common.
Chronic fatigue is a disaster not only for the individual, but also a major social problem. Besides the people who suffer from CFS, experts estimate around 80,000, there are also others who are dealing with extreme fatigue. For example, people who have been treated for cancer or people with chronic illness. Many chronic diseases are known to be associated with severe fatigue. According to Bleijenberg this means that in the Netherlands at least half a million people have chronic fatigue.
For most of his working life Bleijenberg has been involved with chronic fatigue and its treatment. In the Netherlands he developed a form of cognitive behavioral therapy (CBT) which is effective in people with chronic fatigue syndrome. Later it appeared that other people with chronic fatigue will benefit from this form of therapy. Together with his colleagues he developed effective forms of CBT for cancer-related fatigue, chronic fatigue in MS patients and in neuromuscular diseases.
Bleijenberg: What amazes is that there is so little money is allocated to the national introduction of these effective therapies. "There is a lot of money spent on proper investigation into the treatment of fatigue," he says in his farewell speech, "that has produced good treatment (Google translate: cures). These treatments can now be performed by trained behavioral therapists, but there is hardly any money available for their training. The additional behavioral training would be a great way to save money: it would relieve the burden of fatigue and reduce reliance on expensive equipment. "
In his farewell speech, Bleijenberg discussed the mechanism of action of CBT. This is much the same for the various groups with severe fatigue. CBT is effective because it changes the patient's attitudes and thinking about fatigue. Changes in attitudes about physical activity and exercise also have an effect on decreasing fatigue.
Graded exercise therapy (GET), based on gradually increasing physical activity, is also effective for chronic fatigue syndrome. "But here it appears the move [exercise?] itself is not the operative factor," said Bleijenberg. "Even with this therapy, the beliefs about exercise change will be effective."
However, different chronic fatigue states are not the same. The Donders found with the Nijmegen Research Centre Chronic Fatigue, that people with CFS have less gray matter in their brains than healthy people. After treatment with CBT, the volume of gray matter increases. On the other hand, in case of fatigue after cancer, there was no decrease in gray matter, and can be seen therefore, do not increase in gray matter after the treatment. This indicates that CFS is different biologically than cancer-related fatigue.
Something similar can be seen at the level of the hormone cortisol in saliva. In CFS, this content is relatively low and it increases as the cognitive-behavioral starts better. In people who have had cancer, there is no difference in cortisol levels between fatigued and non-fatigued.
The many faces of fatigue
The circumstances preceding the fatigue and the factors that maintain fatigue are differenct between patient groups. Therefore, the therapy for each patient group needs to be adjusted independently. "The many faces of fatigue" is the title of the symposium held to mark the retirement of Bleijenberg. Speakers from home and abroad discuss treatment of chronic fatigue in different groups of patients such as people with MS, COPD and heart disease.
Source: UMCStRadboud@umcn.nl