Predictors of outcome in a multi-component treatment program for CFS

Dolphin

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(This extra info of mine isn't exciting but I wanted to put it somewhere)

The conference abstract below has a little extra info from the abstract of the paper. I don't have the full paper so can't add anything more.

Predictors of outcome in a multi-component treatment program for chronic fatigue syndrome.

J Affect Disord. 2010 Feb 16. [Epub ahead of print]

Kempke S, Goossens L, Luyten P, Bekaert P, Van Houdenhove B, Van Wambeke P.

Department of Psychology, University of Leuven, Leuven, Belgium.

Abstract

BACKGROUND: Little is known about factors predicting treatment outcome in chronic fatigue syndrome (CFS).

METHODS: Based on Vercoulen et al.'s (1998) cognitive-behavioral model of perpetuating factors in CFS, the predictive value of the following patient characteristics were examined in a sample of 178 CFS patients who followed a multi-component treatment program: (1) somatic attributions, (2) psychological attributions, (3) sense of control over symptoms, (4) physical activity, (5) functional impairment, (6) somatic focus, and (7) severity of depression.

RESULTS: Only pre-treatment severity of depression was associated with negative treatment outcome defined in terms of post-treatment fatigue and improvement in fatigue.

LIMITATIONS: The study was conducted at a tertiary care centre and did not include a control group or a long-term follow-up.

CONCLUSIONS: Level of depression may be the most important factor of the cognitive-behavioral model predicting post-treatment fatigue in CFS. Hence, findings suggest that treatment of CFS should include a focus on severity of depression.
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http://www.psychosomaticmedicine.org/misc/abstracttext2009v2.pdf

227) Abstract 1305

IS THERE A LINK BETWEEN THERAPEUTIC OUTCOME IN
CHRONIC FATIGUE SYNDROME AND COMORBID
DEPRESSION?

Boudewijn Van Houdenhove, MD, PhD, Liaison Psychiatry, Patrick
Luyten, PhD, Stefan Kempke, MA, Psychology, University of Leuven,
Leuven, Belgium

Purpose of study:
Although it is assumed that chronic fatigue syndrome
(CFS) and depression may show complex psychobiological links, there
is a paucity of research investigating the role of comorbid depression in
CFS treatment.

Therefore, in this study the impact of comorbid
depression on therapeutic outcome in a large sample of CFS patients
was studied.

Methods:
Quasi-experimental, phase-lagged study of two
multidisciplinary group treatment modalities with different intensity
(weekly versus monthly), carried out in a tertiary care rehabilitation
setting with two groups of CFS patients (n=101 and n=91 respectively).

Both treatments were based on cognitive behavioural principles and
also comprised relaxation exercises, pacing instructions and physical
reconditioning exercises.

Before treatment, comorbid depression was
measured by the Hospital Anxiety and Depression Scale (HADS).

Consistent with the recommended cut-off point for the HADS
depression subscale in CFS patients (Morriss & Wearden, 1998), a
score of 10 or more was used as a cut-off point to categorize patients as
depressed versus non-depressed.

Results:
In both treatment modalities,
therapeutic outcome was very similar.

Moreover, in both conditions
comorbid depression was negatively associated with outcome.

For instance, taking the results of the two groups together, 49.1% (n=57) of
the patients showing no improvement met criteria for depression,
whereas only 26.3% (n=20) of the improved patients were depressed
(chi square = 9.956, p <.05).

Conclusions:
These findings point to the importance of attending to comorbid depression in treating CFS
patients and are in line with the advice to customize CFS treatment to
individual patient characteristics (Van Houdenhove & Luyten, in
press).