(Thesis) Cognitive behaviour therapy for chronic fatigue syndrome Long-term follow-up and Internet-based treatment, 2020, Janse

[Dolphin]

Author
A.L. Janse

Title
Cognitive behaviour therapy for chronic fatigue syndrome

Subtitle
Long-term follow-up and Internet-based treatment

Supervisors
J.A. Knoop
G. Bleijenberg

Award date
15 May 2020

Number of pages
188

ISBN
9789464022247

Document type
PhD thesis

Faculty
Faculty of Medicine (AMC-UvA)

Abstract

Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) was studied in this thesis. Healthy fatigue is temporarily and will generally resolve after a good night sleep or a holidays. However, when fatigue perseveres and disability in daily living develops, one may be classified as a patient with CFS/ME. Without treatment, chances to recover from CFS/ME are low.
Less

The cognitive-behavioural model for CFS/ME assumes that behaviour and beliefs can perpetuate the syndrome. In short, when patients change CFS/ME perpetuating beliefs and gradually increase activity during CBT, patients can attain personal goals and reach fatigue scores within normal limits.

First, long term outcome of CBT for CFS/ME were tested. Also, it was tried to find predictors of these long term results. Secondly, the efficacy of CBT for less severe CFS/ME patients was determined. Thirdly, the efficacy and efficiency of an internet version of the regular CBT for CFS/ME was determined.

A large subgroup of well-treated patients with CBT could remain the benefits of treatment at long-term follow-up. Fatigue severity and the level of physical functioning at end of CBT, mainly predicted fatigue severity and physical functioning level at long term.
Patients with less severe symptoms that not fulfil full CFS/ME criteria could efficaciously be treated with a minimal (CBT-) intervention.

Finally, CBT for CFS/ME via internet was efficacious and time efficient. Spare therapist time can be reduced with internet CBT.

Permalink
https://hdl.handle.net/11245.1/1d69c537-8d30-4f1f-b59d-ef9be0a6ef8e
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  Thesis https://pure.uva.nl/ws/files/47376767/Thesis.pdf

 

[cassava7]

The cognitive-behavioural model for CFS/ME assumes that behaviour and beliefs can perpetuate the syndrome.

3+ years of work wasted on a wrong assumption.

When a diagnostic biomarker is found, should all the PhD and Masters thesis on GET/CBT and ME be voided and the degrees of their authors stripped?

 

[InitialConditions]

those first couple of sentences in the abstract couldn't be more wrong. this looks like master's-level work at best, but I think it's PhD.

 

[Sly Saint]

Supervisors
J.A. Knoop
G. Bleijenberg

figures

 

[MSEsperanza]

Supervisors
J.A. Knoop
G. Bleijenberg

They are also co-authors of the 6 articles that constitute the thesis.

1st article:

Anthonie Janse, Stephanie Nikolaus, Jan F. Wiborg, Marianne Heins, Jos W.M. van der Meer, Gijs Bleijenberg, Marcia Tummers, Jos Twisk, Hans Knoop, Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome,
Journal of Psychosomatic Research, Volume 97, 2017, https://doi.org/10.1016/j.jpsychores.2017.03.016.

1st article's 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 125 months 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.

The thesis cover:

About the cover:
To me, the pictured judo match represents cognitive behaviour therapy for chronic fatigue syndrome. Is it a fight against (prejudice of) others or against internal symptoms? The answer lies somewhere in the middle. Regardless the answer, it requires skill to overcome.

 

[DigitalDrifter]

However, when fatigue perseveres and disability in daily living develops, one may be classified as a patient with CFS/ME.

ME is an adverse reaction to exercise or exertion not merely fatigue. I don't think it's fair to call this a trial for ME patients.

Imagine if they redefined cancer as 6 months of fatigue, re-branded it as CFS/Cancer and then claimed that CBT and exercise were the best evidenced-based treatments for cancer. Any one who objects is doing so due to the stigma of mental health and is guilty of stigmatizing those with mental health problems. Oh and CFS/Cancer activists are anti science.

 

[rvallee]

Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) was studied in this thesis. Healthy fatigue is temporarily and will generally resolve after a good night sleep or a holidays. However, when fatigue perseveres and disability in daily living develops, one may be classified as a patient with CFS/ME.

Completely clueless and incompetent. That it's acceptable to just make up your own redefinition of something is beyond absurd.

The cognitive-behavioural model for CFS/ME assumes that behaviour and beliefs can perpetuate the syndrome

Decades later, after years of clinical practice, it remains stuck at the starting line, nothing but assumptions about things that can be. True enough. Gotta give credit for that. It's just absurd that this is an acceptable standard, that millions of lives are written off on nothing but the assumptions of ignorant quacks.

Not worth reading through this. All questionnaire based, the abstracts make it clear those are not valid cohorts and no one competent about ME is involved. Pointless waste of everything. This isn't a serious effort.

I'd say I feel sorry for this student but if they can't see through blatant pseudoscience it's probably for the best that they set their career on a path for failure.

 

[spinoza577]

That it's acceptable to just make up your own redefinition of something is beyond absurd.

Kind of free time.

If I would be them and had time to investigate, I would put my honest imagination and fantasy into it. A play with possibilities, as every scientist would like to enjoy, but its every time the same noisy anything.

Completely clueless and incompetent.

Its even more clueless than incompetent.

 

[Jonathan Edwards]

Spare therapist time can be reduced with internet CBT.

So what does that mean exactly? All the glitches on the software mean the therapist has no spare time anymore?

Or is it that you don't need so many spare therapists?

 

[alktipping]

so when did stupidity become a contagious disease . this particular form of wilful ignorance seems to be rampant in institutions that are supposed to educate people to a higher level. all I am constantly seeing is dogma passed on to those to stupid to actually do anything useful with their lives .

 

[Jaybee00]

Will this guy be able to get a job with this outstanding scholarship?