Article

Is cognitive behaviour therapy for chronic fatigue syndrome also effective for pain symptoms?

Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, Post Box 9011, 6525 EC Nijmegen, The Netherlands; Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Department of Internal Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
Behaviour Research and Therapy DOI:10.1016/j.brat.2007.03.002 pp.2034-2043

ABSTRACT Patients with chronic fatigue syndrome (CFS) frequently report chronic pain symptoms. Cognitive behavioural therapy (CBT) for CFS results in a reduction of fatigue, but is not aimed at pain symptoms. In this study, we tested the hypothesis that a successful treatment of CFS can also lead to a reduction of pain. The second objective was to explore possible mechanisms of changes in pain. The third objective was to assess the predictive value of pain for treatment outcome. Data from two previous CBT studies were used, one of adult CFS patients (n=96) and one of adolescent CFS patients (n=32). Pain severity was assessed with a daily self-observation list at baseline and post-treatment. The location of pain in adults was assessed with the McGill Pain Questionnaire (MPQ). Patients were divided into recovered and non-recovered groups. Recovery was defined as reaching a post-treatment level of fatigue within normal range. Recovered adult and adolescent CFS patients reported a significant reduction of pain severity compared to non-recovered patients. Recovered adult patients also had fewer pain locations following treatment. The decrease in fatigue predicted the change in pain severity. In adult patients, a higher pain severity at baseline was associated with a negative treatment outcome.

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    Article: Does depression mediate the relation between fatigue severity and disability in chronic fatigue syndrome sufferers?
    Katherine Hadlandsmyth, Kevin E Vowles
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    ABSTRACT: Chronic fatigue syndrome (CFS) is often associated with significant levels of disability. Although fatigue and depression have been found to be independently related to severity of disability, it is not clear how these three factors are mutually related. The present study sought to address this issue by specifically testing a model of mediation whereby depression was hypothesized to influence relations between fatigue and disability. Participants included 90 individuals seeking treatment for CFS at a tertiary care facility. Each provided demographic information and completed standardized measures of depression and fatigue severity, as well as a measure of disability, which assessed difficulties in physical, psychosocial, and independence domains. Analyses indicated that depression and fatigue were positively correlated with one another, as well as all three disability domains. Analyses of mediation indicated that depression completely mediated the relation between fatigue and psychosocial disability and partially mediated the relation between fatigue and the other two disability domains. Indirect effects tests indicated that the inclusion of depression in the statistical models was statistically meaningful. These results replicate previous findings that fatigue and depression are independently related to disability in those with CFS. A more complex statistical model, however, suggested that depression severity substantially influenced the strength of the relation between fatigue and disability levels across a range of domains, including complete mediation in areas involving psychosocial functioning. These results may aid in clarifying contemporary conceptualizations of CFS and provide guidance in the identification of appropriate treatment targets.
    Journal of Psychosomatic Research 02/2009; 66(1):31-5. · 3.30 Impact Factor
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Keywords

adolescent CFS patients
 
adult CFS patients
 
adult patients
 
adults
 
CFS results
 
chronic fatigue syndrome
 
Cognitive behavioural therapy
 
higher pain severity
 
McGill Pain Questionnaire
 
negative treatment outcome
 
non-recovered groups
 
non-recovered patients
 
pain locations
 
pain symptoms
 
Patients
 
previous CBT studies
 
Recovered adult
 
Recovered adult patients
 
self-observation list
 
treatment outcome