Cognitive-behaviour therapy for chronic fatigue syndrome: comparison of outcomes within and outside the confines of a randomised controlled trial

TY - JOUR

T1 - Cognitive-behaviour therapy for chronic fatigue syndrome

T2 - comparison of outcomes within and outside the confines of a randomised controlled trial

AU - Quarmby, Louise

AU - Rimes, Katharine

AU - Deale, Alicia

AU - Wessely, Simon

AU - Chalder, Trudie

PY - 2007/6

Y1 - 2007/6

N2 - Outcomes for cognitive-behaviour therapy (CBT) in randomised controlled trials (RCTs) have rarely been compared to those in routine clinical practice. Taking the case of CBT for chronic fatigue syndrome (CFS), we evaluated the results of a successful RCT against those of the same treatment given in the same setting as part of routine practice. Fatigue and social adjustment scores were compared for patients who received CBT for CFS as part of a RCT (N = 30) and patients who received CBT as part of everyday clinical practice (N = 384).The results in the RCT were superior to those in routine clinical practice. Between pre-treatment and 6-month follow-up, the RCT showed a larger reduction in fatigue and greater improvement in social adjustment than those in routine treatment. The changes in fatigue scores were similar for both groups during treatment but were greater in the RCT between post-treatment and follow-up.Potential reasons for the superior results of the RCT include patient selection, therapist factors and the use of a manualised treatment protocol. Practitioners need to pay particular attention to relapse prevention and ensuring adequate follow-up in addition to encouraging patients to continue with cognitive-behavioural strategies once treatment has ended. (c) 2006 Elsevier Ltd. All rights reserved.

AB - Outcomes for cognitive-behaviour therapy (CBT) in randomised controlled trials (RCTs) have rarely been compared to those in routine clinical practice. Taking the case of CBT for chronic fatigue syndrome (CFS), we evaluated the results of a successful RCT against those of the same treatment given in the same setting as part of routine practice. Fatigue and social adjustment scores were compared for patients who received CBT for CFS as part of a RCT (N = 30) and patients who received CBT as part of everyday clinical practice (N = 384).The results in the RCT were superior to those in routine clinical practice. Between pre-treatment and 6-month follow-up, the RCT showed a larger reduction in fatigue and greater improvement in social adjustment than those in routine treatment. The changes in fatigue scores were similar for both groups during treatment but were greater in the RCT between post-treatment and follow-up.Potential reasons for the superior results of the RCT include patient selection, therapist factors and the use of a manualised treatment protocol. Practitioners need to pay particular attention to relapse prevention and ensuring adequate follow-up in addition to encouraging patients to continue with cognitive-behavioural strategies once treatment has ended. (c) 2006 Elsevier Ltd. All rights reserved.

KW - routine clinical practice

KW - SCALE

KW - cognitive-behaviour therapy

KW - PSYCHOTHERAPY

KW - CLINICAL-TRIALS

KW - chronic fatigue syndrome

KW - clinical trials

U2 - 10.1016/j.brat.2006.08.019

DO - 10.1016/j.brat.2006.08.019

M3 - Article

C2 - 17074300

SN - 0005-7967

VL - 45

SP - 1085

EP - 1094

JO - Behaviour Research and Therapy

JF - Behaviour Research and Therapy

IS - 6

ER -