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Cognitive behaviour therapy for the chronic fatigue syndrome: a randomised controlled trial.
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Abstract Objective : To evaluate the acceptability and efficacy of adding cognitive behaviour therapy to the medical care of patients presenting with the chronic fatigue syndrome. Design : Randomised controlled trial with final assessment at 12 months. Setting : An infectious diseases outpatient clinic. Subjects : 60 consecutively referred patients meeting consensus criteria for the chronic fatigue syndrome. Interventions : Medical care comprised assessment, advice, and follow up in general practice. Patients who received cognitive behaviour therapy were offered 16 individual weekly sessions in addition to their medical care. Main outcome measures : The proportions of patients (a) who achieved normal daily functioning (Karnofsky score 80 or more) and (b) who achieved a clinically significant improvement in functioning (change in Karnofsky score 10 points or more) by 12 months after randomisation. Results : Only two eligible patients refused to participate. All randomised patients completed treatment. An intention to treat analysis showed that 73% (22/30) of recipients of cognitive behaviour therapy achieved a satisfactory outcome as compared with 27% (8/30) of patients who were given only medical care (difference 47 percentage points; 95% confidence interval 24 to 69). Similar differences were observed in subsidiary outcome measures. The improvement in disability among patients given cognitive behaviour therapy continued after completion of therapy. Illness beliefs and coping behaviour previously associated with a poor outcome changed more with cognitive behaviour therapy than with medical care alone. Conclusion : Adding cognitive behaviour therapy to the medical care of patients with the chronic fatigue syndrome is acceptable to patients and leads to a sustained reduction in functional impairment. Key messages Key messages There is no generally accepted form of treatment New findings show that patients referred to hospital for the chronic fatigue syndrome have a better outcome if they are given a course of cognitive behaviour therapy than if they receive only basic medical care Clinical improvement with cognitive behaviour therapy may be slow but often continues after treatment has ended Cognitive behaviour therapy should be considered as an option for patients presenting with the chronic fatigue syndrome
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“CBT has been adapted and tested with CFS patients yielding superior results compared to standard medical treatment, relaxation, and adaptive pacing therapy (Sharpe et al., 1996; Deale et al., 1997; White et al., 2011), with moderate effect sizes (d = 0.48) (Malouff et al., 2008).”
From The relationship between improvement in insomnia severity and long-term outcomes in the treatment of chronic fatigue (2018) · cites this paper as Sharpe et al., 1996
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임경혜, & 심은정 (2015) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2015.20.1.008 · Cited by 3
&NA; (2003) · The Nurse Practitioner · doi:10.1097/00006205-200302000-00023 · Cited by 3
Wessely, S. C. (1999) · Springer eBooks · doi:10.1007/978-4-431-68500-5_10 · Cited by 4
Kapfhammer, H. (2011) · Springer eBooks · doi:10.1007/978-3-642-03637-8_61 · Cited by 3
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Metadata
- Authors
- Sharpe, M., Hawton, K., Simkin, S., Surawy, C., Hackmann, A., Klimes, I., Peto, T., Warrell, D., & Seagroatt, V.
- Affiliations
- Warneford Hospital (GB)
- John Radcliffe Hospital (GB)
- University of Oxford (GB)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1996-01-06
- Volume
- 312
- Issue
- 7022
- Pages
- 22-26
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2349693
- OpenAlex
- W2023718291
- Cited by
- 528
- References
- 27
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 1 · 2020: 7 · 2019: 7 · 2018: 3 · 2017: 9 · 2016: 7 · 2015: 14 · 2014: 11 · 2013: 14 · 2012: 19
- FWCI
- 47.30
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Keywords
- chronic fatigue syndrome, cognitive behavioral therapy, health care, functional disability, Karnofsky performance status, illness beliefs, coping behaviour, treatment acceptability, treatment efficacy
- MeSH terms
- Adaptation, Psychological, Adult, Attitude to Health, Depression, Female, Humans, Male, Patient Compliance, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Treatment Outcome
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