Predictors of outcome in a multi-component treatment program for chronic fatigue syndrome

Abstract

Background Little is known about factors predicting treatment outcome in chronic fatigue syndrome (CFS). Methods Based on Vercoulen et al.'s (1998) cognitive–behavioral model of perpetuating factors in CFS, the predictive value of the following patient characteristics were examined in a sample of 178 CFS patients who followed a multi-component treatment program: (1) somatic attributions, (2) psychological attributions, (3) sense of control over symptoms, (4) physical activity, (5) functional impairment, (6) somatic focus, and (7) severity of depression. Results Only pre-treatment severity of depression was associated with negative treatment outcome defined in terms of post-treatment fatigue and improvement in fatigue. Limitations The study was conducted at a tertiary care centre and did not include a control group or a long-term follow-up. Conclusions Level of depression may be the most important factor of the cognitive–behavioral model predicting post-treatment fatigue in CFS. Hence, findings suggest that treatment of CFS should include a focus on severity of depression.