Effectiveness of an ACT‐based rehabilitation program for the treatment of chronic fatigue: Results from a 12‐months longitudinal study, 2020, Brugnera

My bolding.

So they jumbled together people with all sorts of pain, depression and fatigue, and diagnosed them all with 'chronic fatigue', citing loads of CFS studies to back up their assumptions.

Sad that they seem to have no idea ME exists, let alone what it is. This study is meaningless.

Edit: and there was no control group.

Second edit: And they only had results for a little over half the patients at 12 month follow up. It gets more and more useless.

 

An 'increase in work hours' if a person's work hours before treatment was 0 certainly may not be very impressive. Add in the lack of a control arm and what seems to be a massive dropout for the final follow-up survey, and, well, it's less than convincing.

 

Worth repeating.

So physical health QoL didn't improve. But, never mind, that's not the aim with ACT.

Whack-a-mole - if CBT is finally discarded as the treatment of choice, there's another therapy to take its place. And this one doesn't have to show any objective improvement in anything.

The treatment was a 3.5 week inpatient programme! The cost of such a treatment must be enormous.

There was no control, people! Argh

 

Another typical problem of studies like this is the use of survey instruments without giving comparison figures for healthy populations, or, ideally, populations of people with a clearly physical and disabling health condition. There's an implicit assumption that the way sick people think is faulty, without any evidence.

For example the Metacognition Questionnaire. I can't easily find good comparison data, but there is a Wells and Cartright Hatton 2004 study that reported that the mean score was 52 in men and 47 in women, with a standard deviation for each of about 13.5. This was in a sample of convenience of university and health-service employees.

The study that is the subject of the thread reported that the MCQ score pre-treatment was 54 (SD 12). After treatment it was 51 (11). If you look at the questions, there's a section on cognitive confidence, e.g. 'My memory can mislead me at times'. So, it would not be surprising for someone with an illness that involves cognition issues at times to have a total score that is a bit higher.

I haven't spent enough time on this to be sure, and it looks like there are various weightings that can be given to the questions. But it's looking to me as though a very large percentage of the sample population of this study had perfectly normal metacognition scores. To then spend 3.5 weeks training these people to see the world differently and only have the tiny change in reported outcome seems a failure in itself, without us even needing to mention the lack of a change in reported physical quality of life.

 

This study reads more like promotional material for the rehab clinic, not serious science. I assume the study was done by the clinic staff who want to sell their inpatient rehab program to employers or government benefits agencies.