reported in the Lancet paper, there was no difference in the change
between CBT + Specialist Medical Care (SMC), SMC and Adaptive Pacing
Therapy (APT). The numbers were almost exactly the same when adjusted:
SMC alone was 1.5m better than CBT + SMC which was 4.2m better than
APT but none of these differences were significant]Vol. 80, No. 6,
2011
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Regular Article
Does the Heterogeneity of Chronic Fatigue Syndrome Moderate the
Response to Cognitive Behaviour Therapy? An Exploratory Study
Matteo Cella a, b, Trudie Chalder a, Peter D. White c
aDepartment of Psychological Medicine, Institute of Psychiatry, King=92s
College London,
bDepartment of Clinical, Educational and Health Psychology, University
College London, and
cCenter for Psychiatry, Wolfson Institute of Preventive Medicine,
Barts and the London School of Medicine, Queen Mary University,
London, UK
Address of Corresponding Author
Psychother Psychosom 2011;80:353-358 (DOI: 10.1159/000327582)
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Key Words
Chronic fatigue syndrome
Cognitive behaviour therapy
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Abstract
(I've given each sentence its own paragraph)
Background:
Chronic fatigue syndrome (CFS) is a heterogeneous condition.
A few studies have shown that some independent factors predict
outcomes after cognitive behaviour therapy (CBT).
Two recent systematic reviews suggest that heterogeneity may moderate
treatment outcomes.
However, no study has explored whether subgroups of CFS predict
response to treatment.
Methods:
We used both latent class analysis (LCA) and latent class regression
(LCR) to clarify the relationship between subgroups of CFS patients (n
=3D 236), diagnosed using the Oxford diagnostic criteria, and the
response to CBT.
We measured symptoms, demographics, mood, and cognitive and
behavioural responses to illness to define subgroups.
Results:
We found 5 latent classes by LCA, which did not differ in the
direction of their response to CBT, with all classes showing
improvement.
In contrast, an exploratory LCR identified 4 latent classes, 1 of
which predicted a poor response to CBT, whereas the other 3 predicted
a good outcome, accounting for more than 70% of the patients.
The negative outcome class was defined by weight fluctuations and
physical shakiness, anxiety, pain and being focused on symptoms.
Conclusions:
CBT should be offered to all classes of patients with CFS, when
defined by these measures.
It may be possible to predict a minority group with a negative
outcome, but this exploratory work needs replication.
Copyright =A9 2011 S. Karger AG, Basel
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Author Contacts
Matteo Cella
King=92s College London, Institute of Psychiatry, Department of
Psychological Medicine
Weston Education Centre, Cutcombe Rd
London SE5 9RJ (UK)
Tel. +44 20 3228 3191, E-Mail matteo.cella@kcl.ac.uk
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Article Information
Received: November 11, 2010
Accepted after revision: March 13, 2011
Published online: August 6, 2011
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 2, Number of References : 48
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