Randomised Controlled Trial of Cognitive Behaviour Therapy Delivered in Groups of Patients with Chronic Fatigue Syndrome
Abstract
Background: Meta-analyses have been inconclusive about the efficacy of cognitive behaviour therapies (CBTs) delivered in groups of patients with chronic fatigue syndrome (CFS) due to a lack of adequate studies. Methods: We conducted a pragmatic randomised controlled trial with 204 adult CFS patients from our routine clinical practice who were willing to receive group therapy. Patients were equally allocated to therapy groups of 8 patients and 2 therapists, 4 patients and 1 therapist or a waiting list control condition. Primary analysis was based on the intention-to-treat principle and compared the intervention group (n = 136) with the waiting list condition (n = 68). The study was open label. Results: Thirty-four (17%) patients were lost to follow-up during the course of the trial. Missing data were imputed using mean proportions of improvement based on the outcome scores of similar patients with a second assessment. Large and significant improvement in favour of the intervention group was found on fatigue severity (effect size = 1.1) and overall impairment (effect size = 0.9) at the second assessment. Physical functioning and psychological distress improved moderately (effect size = 0.5). Treatment effects remained significant in sensitivity and per-protocol analyses. Subgroup analysis revealed that the effects of the intervention also remained significant when both group sizes (i.e. 4 and 8 patients) were compared separately with the waiting list condition. Conclusions: CBT can be effectively delivered in groups of CFS patients. Group size does not seem to affect the general efficacy of the intervention which is of importance for settings in which large treatment groups are not feasible due to limited referral.
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For fatigue, there was one outlier [33], as well as for perceived health status [46], non-completion [29], and treatment refusal [43].
“For fatigue, there was one outlier [33] as well as for perceived health status [46], non-completion [29], and treatment refusal [43].”
From Efficacy and Acceptance of Cognitive Behavioral Therapy in Adults with Chronic Fatigue Syndrome: A Meta-analysis. (2024) · cites this paper as [33]
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- Authors
- Wiborg, J. F., van Bussel, J., van Dijk, A., Bleijenberg, G., & Knoop, H.
- Affiliations
- Radboud University Medical Center (NL)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2015
- Volume
- 84
- Issue
- 6
- Pages
- 368-376
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W1797720768
- Cited by
- 52
- References
- 22
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 11 · 2018: 3 · 2017: 8 · 2016: 4 · 2015: 1
- FWCI
- 4.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- chronic fatigue syndrome, cognitive behavioral therapy, group therapy, group size, waitlist control, fatigue severity, functional disability, physical function, psychological distress, treatment efficacy
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Psychotherapy, Group, Severity of Illness Index, Waiting Lists, Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Treatment Outcome
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