Hulpvraag en therapeutische relatie bij onverklaarde chronische vermoeidheid

Abstract

Help-seeking preferences and therapeutic relationship in unexplained chronic fatigue Research indicates that in functional somatic disorders the request for therapeutic help is related to either medical symptoms or interpersonal problems. We test whether a specific type of request for help is present in a sample of primary care patients with either chronic fatigue syndrome; a chronic cardiovascular or auto-immune disease; or a minor medical condition. In this study 155 primary care patients were recruited through 52 primary care practitioners: 52 chronic fatigue syndrome (CFS) patients; 52 patients with a cardiovascular or auto-immune disease; 51 patients with a minor medical condition. Interpersonal problems were assessed by means of the Inventory for Patients’ Request for Help (HLV). Chronic Fatigue Syndrome was measured with the Checklist Individual Strength (CIS); alexithymia was assessed by means of the Toronto Alexithymia Scale (TAS-20); and the driven and impatient interpersonal functioning by the Jenkins Activity Survey (JAS). Results indicate that CFS patients have a significantly more consumer related request for help with the emphasis on symptom reduction. Prolonged and debilitating fatigue was significantly related to a request for medical and liaison-psychiatric help; a help request in a more impatient functioning is related to higher complaint behavior; and alexithymia was related to a request for specific medical aid. We found no specific therapeutic relationship in Chronic Fatigue Syndrome. We conclude that the exact status of the therapeutic relationship in CFS and cardiovascular or auto-immune disease remains undecided, but clearly the request for consumer help and symptom reduction is related to CFS as a population.