Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome

Anthonie Janse; Stephanie Nikolaus; Jan F Wiborg; Marianne Heins; Jos W M van der Meer; Gijs Bleijenberg; Marcia Tummers; Jos Twisk; Hans Knoop

doi:10.1016/j.jpsychores.2017.03.016

Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome

J Psychosom Res. 2017 Jun;97:45-51. doi: 10.1016/j.jpsychores.2017.03.016. Epub 2017 Mar 27.

Authors

Anthonie Janse¹, Stephanie Nikolaus², Jan F Wiborg², Marianne Heins², Jos W M van der Meer³, Gijs Bleijenberg⁴, Marcia Tummers⁵, Jos Twisk⁶, Hans Knoop⁷

Affiliations

¹ Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands; Academic Medical Center (AMC), University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
² Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands.
³ Department of Internal Medicine, Radboud university medical center, Nijmegen, The Netherlands.
⁴ Radboud university medical center, Nijmegen, The Netherlands.
⁵ Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands.
⁶ Department of Methodology and Applied Biostatistics, Vrije Universiteit, Amsterdam, The Netherlands.
⁷ Expert Center for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, The Netherlands; Academic Medical Center (AMC), University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health research institute, Amsterdam, The Netherlands. Electronic address: hans.knoop@amc.uva.nl.

PMID: 28606498
DOI: 10.1016/j.jpsychores.2017.03.016

Abstract

Objective: Cognitive behaviour therapy (CBT) is an effective treatment for chronic fatigue syndrome (CFS). Main aim was to determine whether treatment effects were maintained up to 10years after treatment.

Methods: Participants (n=583) of previously published studies on the effects of CBT for CFS were contacted for a long-term follow-up assessment. They completed questionnaires on main outcomes fatigue severity (CIS) and physical functioning (SF-36). The course of these outcomes since post-treatment assessment was examined using mixed model analyses.

Results: Between 21 and 125months after finishing CBT, 511 persons (response rate 88%) completed a follow-up assessment. At follow-up, mean fatigue severity was significantly increased to 37.60 (SD=12.76) and mean physical functioning significantly decreased to 73.16 (SD=23.56) compared to post-treatment assessment. At follow-up still 37% of the participants had fatigue scores in the normal range and 70% were not impaired in physical functioning.

Conclusion: Positive effects of CBT for CFS on fatigue and physical functioning were partly sustained at long-term follow-up. However, a subgroup of patients once again reported severe fatigue, and compromised physical functioning. Further research should elucidate the reasons for this deterioration to facilitate the development of treatment strategies for relapse prevention.

Keywords: CBT; CFS; Chronic fatigue syndrome; Cognitive behaviour therapy; Follow-up; Long-term effects; Long-term follow-up.

MeSH terms

Adult
Cognitive Behavioral Therapy / methods*
Fatigue Syndrome, Chronic / psychology*
Female
Follow-Up Studies
Humans
Long-Term Care
Male
Middle Aged
Surveys and Questionnaires
Treatment Outcome