A Randomized Controlled Trial of Cognitive Behavior Therapy for Multiple Sclerosis Fatigue
Abstract
BACKGROUND: The purpose of this study was to assess the efficacy of cognitive behavior therapy (CBT) as a treatment for multiple sclerosis (MS) fatigue. METHODS: A randomized controlled design was used where 72 patients with MS fatigue were randomly assigned to eight weekly sessions of CBT or relaxation training (RT). RT was designed to control for therapist time and attention. Participants were assessed before and after treatment, and at 3 and 6 months posttreatment. The primary outcome was the Fatigue Scale. Secondary outcomes included measures of stress, mood, and fatigue-related impairment. RESULTS: Analysis was by intention-to-treat. A group by time interaction showed that the CBT group reported significantly greater reductions in fatigue across the 8 months compared with the RT group (p < .02). Calculated effect sizes for fatigue from baseline to the end of treatment were 3.03 [95% confidence interval, 2.22-3.68] for the CBT group and 1.83 [95% confidence interval, 1.26-2.34] for the RT group. Results also indicted that both groups showed clinically significant decreases in fatigue defined as fatigue levels equivalent or less than those reported by a non-fatigued healthy comparison group. There were no significant interactions between group and any of the secondary outcome variables, with both groups showing improvements over time on all measures. INTERPRETATION: Both CBT and RT appear to be clinically effective treatments for fatigue in MS patients, although the effects for CBT are greater than those for RT. Even 6 months after treatment, both treatment groups reported levels of fatigue equivalent to those of the healthy comparison group.
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In previous meta-analysis papers, CMAC was presented mostly in group and in eight weekly sessions.
“Similar to the studies incorporated in the present paper, CMAC was presented mostly in group and in eight weekly sessions in the previous meta-analysis papers.”
Van Kessel et al. compared CBT and relaxation therapies and found that CBT led to more significant improvement in fatigue, depression, anxiety, and stress in patients with multiple sclerosis.
“VanKesseletal. (47)compared CBT and relaxation therapies, and found that CBT lead to more significant improvement in the extent of fatigue, depression, anxiety, and stress of PwMS.”
These and other studies have often used individual therapy, and findings have mainly focused upon single dimensions of well-being, e.g., depression or fatigue.
“However, these and other studies have often used individual therapy, and findings have mainly focused upon single dimensions of well-being, e.g., depression or fatigue.”
From MS quality of life, depression, and fatigue improve after mindfulness training: A randomized trial (2010) · cites this paper as [39]
Several previous controlled trials of cognitive-behavioral interventions have shown benefits upon depression, fatigue, or anxiety in patients with MS.
“Several previous controlled trials of cognitive-behavioral interventions have shown benefits upon depression, fatigue, or anxiety in patients with MS.19,38,39”
From MS quality of life, depression, and fatigue improve after mindfulness training: A randomized trial (2010) · cites this paper as [39]
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- Authors
- van Kessel, K., Moss-Morris, R., Willoughby, E., Chalder, T., Johnson, M. H., & Robinson, E.
- Corresponding author
- Moss-Morris, Rona
- Venue
- Psychosomatic Medicine
- Published
- 2008-02
- Volume
- 70
- Issue
- 2
- Pages
- 205-213
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2095809030
- Cited by
- 276
- References
- 36
- Citations by year
- 2026: 5 · 2025: 16 · 2024: 9 · 2023: 9 · 2022: 10 · 2021: 24 · 2020: 9 · 2019: 16 · 2018: 14 · 2017: 30 · 2016: 20 · 2015: 26 · 2014: 16 · 2013: 15 · 2012: 16
- FWCI
- 9.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- ResearchSpace (University of Auckland) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- multiple sclerosis, fatigue, cognitive behavioral therapy, relaxation training, treatment efficacy, stress, mood, psychotherapy
- MeSH terms
- Adult, Fatigue, Female, Humans, Male, Manuals as Topic, Multiple Sclerosis, Relaxation Therapy, Cognitive Behavioral Therapy
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