Therapy For Chronic Fatigue Syndrome Research Articles

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study

BackgroundThe response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time. Methods297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships. ResultsLCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional. ConclusionsOn a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.

The effect of massage on patients with chronic fatigue syndrome: A systematic review and meta-analysis.

Chronic fatigue syndrome (CFS) is a long-term and complex chronic disease that seriously affects the physical and mental health and quality of life of patients. Massage, as one of the methods in traditional Chinese medicine, can treat both symptoms and root causes and is widely used to treat CFS. The main purpose is to systematically evaluate the impact of massage therapy on the efficacy and safety of CFS patients, providing a reference for clinical practice. By searching for literature published in PubMed, Cochrane Library, Web of Science, Embase, Wanfang Database, VIP Database, and China National Knowledge Infrastructure Database until November 2023, randomized controlled trial studies were selected according to the established inclusion and exclusion criteria. The Cochrane system evaluation manual was used to evaluate the quality of the included studies, and RevMan5.4 software was used for meta-analysis. 32 randomized controlled trials were included, with a total of 2594 CFS patients. Meta-analysis showed that the total score of the fatigue scale (FS-14) in the treatment group, MD = -1.59, 95% CI (-1.84, -1.34), P < .00001; Physical fatigue score, MD = -1.30, 95% CI (-1.60, -1.00), P < .00001; Mental fatigue score, MD = -0.84, 95% CI (-0.99, -0.72), P < .0001]; Effective rate [RR = 1.23, 95% CI (1.19,1.28), P < .00001]; all indicators were superior to the control group, Only one study reported adverse reactions, including local swelling, skin bruising, and nausea. Our research findings suggest that massage therapy has a significant therapeutic effect on CFS, avoiding adverse reactions and improving fatigue symptoms. Therefore, massage therapy for chronic fatigue syndrome should be further promoted and applied.

Eye Movement Desensitization and Reprocessing Therapy in Chronic Fatigue Syndrome: A Single-Case Experiment Testing the Effect on Persistent Negative Evaluation of Fatigue

Background:While cognitive behavioral therapy (CBT) for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) can lead to the normalization of fatigue levels and resumption of activities, a subgroup of patients still evaluates fatigue negatively.Objective:The objective was to investigate whether eye movement desensitization and reprocessing (EMDR) therapy leads to a less negative evaluation of fatigue.Method:This was a randomized single-case experimental study. Five CFS/ME patients (all female, mean age of 35 years), who had completed CBT but still evaluated fatigue negatively, received EMDR therapy. The primary outcome, that is, negative evaluation of fatigue, was assessed daily (three items, e.g., “My fatigue is frustrating”). During EMDR therapy sessions, distress in response to a selected image was measured. Clinical assessments were performed before, directly after, and one month after EMDR therapy.Results:During EMDR therapy sessions, all patients reported high distress related to memories of having CFS/ME. EMDR therapy led to a reduction in this distress. Daily measured negative evaluations of fatigue declined in three patients, albeit not significantly. Three of five patients showed clinically relevant improvement in evaluations of fatigue on clinical pre-/post measures.Conclusion:EMDR therapy can reduce emotional distress associated with fatigue, but it is unclear whether it can change its negative evaluation.

New NICE guideline on chronic fatigue syndrome: more ideology than science?

The National Institute for Health and Care Excellence (NICE) in the UK published a new chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) guideline in October, 2021. 1 National Institute for Health and Care ExcellenceMyalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management. NICE guideline [NG206]. https://www.nice.org.uk/guidance/ng206Date: Oct 29, 2021 Date accessed: January 13, 2022 Google Scholar The previous NICE 2007 guideline recommended cognitive behavioural therapy (CBT) and graded exercise therapy (GET) for people with mild or moderate CFS/ME based on evidence from randomised trials. 2 Baker R Shaw EJ Diagnosis and management of chronic fatigue syndrome or myalgic encephalomyelitis (or encephalopathy): summary of NICE guidance. BMJ. 2007; 335: 446-448 Crossref PubMed Scopus (79) Google Scholar Since then, more randomised trials and systematic reviews have provided additional evidence supporting these recommendations. 3 Price JR Mitchell E Tidy E Hunot V Cognitive behaviour therapy for chronic fatigue syndrome in adults. Cochrane Database Syst Rev. 2008; 3CD001027 Google Scholar , 4 Larun L Brurberg KG Odgaard-Jensen J Price JR Exercise therapy for chronic fatigue syndrome. Cochrane Database Syst Rev. 2019; 10CD003200 PubMed Google Scholar , 5 Castell BD Kazantzis N Moss-Morris R Cognitive behavioral therapy and graded exercise for chronic fatigue syndrome: a meta-analysis. Clin Psychol Sci Pract. 2011; 18: 311-324 Crossref Scopus (133) Google Scholar , 6 White PD Goldsmith KA Johnson AL et al. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet. 2011; 377: 823-836 Summary Full Text Full Text PDF PubMed Scopus (622) Google Scholar , 7 Nijhof SL Bleijenberg G Uiterwaal CS et al. Effectiveness of internet-based cognitive behavioural treatment for adolescents with chronic fatigue syndrome (FITNET): a randomised controlled trial. Lancet. 2012; 379: 1412-1418 Summary Full Text Full Text PDF PubMed Scopus (153) Google Scholar , 8 Gotaas ME Stiles TC Bjørngaard JH Borchgrevink PC Fors EA Cognitive behavioral therapy improves physical function and fatigue in mild and moderate chronic fatigue syndrome: a consecutive randomized controlled trial of standard and short interventions. Front Psychiatry. 2021; 12580924 Crossref PubMed Scopus (6) Google Scholar No new or more effective interventions have been identified. Although we applaud guideline efforts, it is remarkable that recommendations in the 2021 NICE guideline differ substantially from the previous one, and do not include CBT and GET as means to treat CFS/ME. The new guideline presents strengthened evidence, but a major shift in interpretation. How could this happen?

Research on Neural Network-based Cognitive Behavioral Therapy for Chronic Fatigue Syndrome

Cognitive behavioral therapy (CBT) A structured, short-range, cognitive-oriented psychotherapy method developed by A.T. Drake in the 1960s, which mainly targets mental illnesses such as depression and anxiety disorders and psychological problems caused by irrational cognition.It mainly focuses on the unreasonable cognitive problems of patients, and changes the psychological problems by changing the views and attitudes of patients towards themselves, people or things.Cognitive-behavioral therapy based on neural network is a way to achieve cognitive-behavioral therapy by obtaining computer programs through the Internet. The collected data were screened and meta-analyzed through meta-analytic studies and randomized controlled experiments of web-based cognitive behavioral therapy interventions to form applied random-effects models, or fixed-effects models for combined effect sizes. Through the use of online cognitive behavioral therapy to compare the differences between the treatment group and the control group in terms of overall state, fatigue level, physical function, etc., it is found that cognitive behavioral therapy can improve the overall state of chronic fatigue syndrome, reduce fatigue symptoms, and improve physical function. have significant effects.

Efficacy and safety of Ma's Bamboo-based medicinal moxibustion therapy for chronic fatigue syndrome

Abstract Background: Chronic fatigue syndrome (CFS) is a recurrent functional disease with an unknown pathogenesis. Modern treatment mainly focuses on symptomatic and supportive care, but no specific treatment has emerged. Ma's Bamboo-based Medicinal Moxibustion therapy is a folk traditional Chinese medicine developed in Jinsha County, Guizhou Province. Over a long period of practice in the primary health care setting, it has been confirmed in folk medicine that the therapy can significantly improve the symptoms of patients with CFS, but there is no sufficient and scientific clinical evidence. Therefore, this randomised controlled pilot study was designed to preliminarily evaluate the efficacy and safety of Ma's Bamboo-based Medicinal Moxibustion therapy. Methods/design: This is a parallel, randomized, controlled, and exploratory study. Sixty patients with CFS admitted to the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine will be randomly assigned to the experimental or control group. The experimental group will receive Ma's Bamboo-based Medicinal Moxibustion therapy, whereas the control group will undergo conventional acupuncture. Both groups will be treated once daily for 6 consecutive days as a course of treatment, and two courses separated by 1 day will be completed (12 total treatments). All patients will undergo follow-up after the end of treatment. The baseline period is 2 days. The Fatigue Assessment Instrument score as the primary efficacy measure and secondary efficacy measures, including the Clinical Symptom Score and Fatigue Scale-14, will be evaluated at baseline, after one and two courses of treatment, and during follow-up. Serum T lymphocyte subset counts (CD3 +, CD4 +, CD8 +, CD4 +/CD8 +) and safety measures ((blood routine test, liver and kidney function and electrocardiogram) will be evaluated at baseline and after two courses of treatment. All adverse events occurring between baseline and the end of follow-up will be summarised at the end of the follow-up. Discussion: The results of this trial will clarify whether Ma's Bamboo-based Medicinal Moxibustion therapy can improve the symptoms of patients with CFS and provide preliminary evidence for the effectiveness and safety of Ma's Bamboo-based Medicinal Moxibustion therapy for this indication. Ethics approval: This study has been approved by the Ethics Review Committee of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine (No.K2020–038). Trial Registration: Chinese Clinical Trial Registry, ChiCTR2000038860. Registered on 7 October 2020.

Moxibustion for Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis.

Objective This review aimed at systematically evaluating the efficacy and safety of moxibustion for chronic fatigue syndrome (CFS). Methods Relevant trials were searched in seven digital databases up to January 2021. After literature screening, data extraction, and literature quality evaluation, the included studies were meta-analyzed using RevMan 5.4 software. The evidence level was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results Fifteen studies involving 1030 CFS participants were included. Meta-analyses showed a favorable effect of moxibustion on the total effective rate compared with acupuncture (OR = 4.58, 95%CI = [2.85, 7.35], P < 0.00001) and drugs (OR = 6.36, 95%CI = [3.48, 11.59], P < 0.00001). Moxibustion also appeared to significantly reduce fatigue severity measured by fatigue scale-14 (FS-14) (WMD = −2.20, 95% CI = [−3.16, −1.24], P < 0.00001) and fatigue assessment instrument (FAI) (WMD = −16.36, 95% CI = [−26.58, −6.14], P=0.002) compared with the control group. In addition, among the 15 included studies, only two studies reported adverse events related to moxibustion, and the symptoms were relatively mild. The quality of evidence based on the 15 included trials was assessed as moderate to very low. Conclusions Based on limited evidence, moxibustion might be an effective and safe complementary therapy for CFS, which can be recommended to manage CFS. Because of the limited level of evidence in this review, further high-quality trials are still needed to confirm these findings.

Cognitive behaviour therapy for chronic fatigue syndrome: Authors' reply, naturalistic outcomes paper

Cognitive behaviour therapy for chronic fatigue syndrome: Authors' reply, naturalistic outcomes paper

The efficacy and safety of moxibustion for chronic fatigue syndrome: A protocol for systematic review and meta-analysis.

Background:The pathogenesis of chronic fatigue syndrome (CFS) is not clear. The main purpose of treatment is to improve autoimmune function and relieve fatigue symptoms. Moxibustion is often used to treat diseases caused by low autoimmunity, especially in relieving fatigue symptoms. It is a superior therapy for CFS in traditional Chinese medicine. At present, there is a lack of the high level clinical evidence to support the moxibustion in the treatment of CFS, so this study will systematically review and analyze the currently available randomized controlled trials to evaluate the efficacy and safety of moxibustion in the treatment of CFS.Methods:We will systematically search PubMed, EMBASE, Cochrane library, Sinomed, CNKI, VIP, and Wanfang Database, ClinicalTrials.gov and Chinese Clinical Trial Registry will also be searched. The time range for the search will be from database activation to March 31, 2021. The randomized controlled trials (RCTs) associated with moxibustion for CFS will be included, regardless of language.We will use the standard proposed in Cochrane Handbook 5.1.0 to assess the bias risk of a single RCT. The main outcome index of the study is Fatigue Assessment Instrument (FAI), secondary outcome indexes will include Fatigue Scale -14 (FS-14), Fatigue Severity Scale (FSS), Pittsburgh sleep quality index (PSQI), natural killer (NK) cells, interleukin- 2 (IL-2), T lymphocyte subsets (CD4+, CD8+), cure rate, total efficiency and adverse reactions. The random effect model meta was used to analyze the effect data of a single RCT. Heterogeneity will be measured by Cochran Q test and I-squared statistics. We will use 2 subgroup analyses to explore the source of heterogeneity. RCTs with high bias risk was excluded and adjustment effect model was used for sensitivity analysis to test the robustness of the meta-analysis results. The publication bias included in RCTs will be assessed by funnel plot and Egger test.Results:This study will objectively and comprehensively evaluate the efficacy and safety of randomized controlled trials of moxibustion in the treatment of chronic fatigue syndrome, and the results will be submitted to peer-reviewed journals for publication.Conclusion:This systematic review will provide clinicians with the latest high-quality evidence for the use of moxibustion in the treatment of chronic fatigue syndrome.INPLASY registration number:INPLASY202140063.

Cognitive behavioural therapy for chronic fatigue and chronic fatigue syndrome: outcomes from a specialist clinic in the UK.

ObjectivesCognitive behavioural therapy is commonly used to treat chronic fatigue syndrome and has been shown to be effective for reducing fatigue and improving physical functioning. Most of the evidence on the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome is from randomised control trials, but there are only a few studies in naturalistic treatment settings. Our aim was to examine the effectiveness of cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic setting and examine what factors, if any, predicted outcome.DesignUsing linear mixed effects analysis, we analysed patients' self-reported symptomology over the course of treatment and at three-month follow-up. Furthermore, we explored what baseline factors were associated with improvement at follow-up.SettingData were available for 995 patients receiving cognitive behavioural therapy for chronic fatigue syndrome at an outpatient clinic in the UK.ParticipantsParticipants were referred consecutively to a specialist unit for chronic fatigue or chronic fatigue syndrome.Main outcome measuresPatients were assessed throughout their treatment using self-report measures including the Chalder Fatigue Scale, 36-item Short Form Health Survey, Hospital Anxiety and Depression Scale and Global Improvement and Satisfaction.ResultsPatients’ fatigue, physical functioning and social adjustment scores significantly improved over the duration of treatment with medium to large effect sizes (|d| = 0.45–0.91). Furthermore, 85% of patients self-reported that they felt an improvement in their fatigue at follow-up and 90% were satisfied with their treatment. None of the regression models convincingly predicted improvement in outcomes with the best model being (R2 = 0.137).ConclusionsPatients’ fatigue, physical functioning and social adjustment all significantly improved following cognitive behavioural therapy for chronic fatigue syndrome in a naturalistic outpatient setting. These findings support the growing evidence from previous randomised control trials and suggest that cognitive behavioural therapy could be an effective treatment in routine treatment settings.

The Relationship Between Childhood Trauma and the Response to Group Cognitive-Behavioural Therapy for Chronic Fatigue Syndrome.

ObjectiveTo examine the relationship between childhood trauma and the response to group cognitive-behavioural therapy (GCBT) for chronic fatigue syndrome (CFS).MethodsA single cohort study conducted in an outpatient university referral center for CFS including a well-documented sample of adult patients meeting the CDC criteria for CFS and having received 9 to 12 months of GCBT. A mixed effect model was adopted to examine the impact of childhood trauma on the treatment response in general and over time. The main outcome measures were changes in fatigue, as assessed with the Checklist Individual Strength (total score), and physical functioning, as gauged with the Short Form 36 Health Survey subscale, with the scales being completed at baseline, immediately after treatment completion and after 1 year.ResultsWe included 105 patients with CFS. Childhood trauma was not significantly associated with the response to GCBT over time on level of fatigue or physical functioning.ConclusionChildhood trauma does not seem to have an effect on the treatment response to dedicated GCBT for CFS sufferers over time. Therefore, in the allocation of patients to this kind of treatment, a history of childhood trauma should not be seen as prohibitive.

The role of partners' fatigue and the patient-partner relationship in the outcome of cognitive behavioural therapy for chronic fatigue syndrome

BackgroundIn chronic fatigue syndrome (CFS) little is known about how partner-related factors influence patients' fatigue symptoms and treatment outcome. We examined partners' fatigue severity, and determined the role of partner-related factors for patients' symptoms and the outcome of cognitive behavioural therapy (CBT). Methods1356 CFS patients and their partners completed baseline measures of fatigue severity (Checklist Individual Strength), causal attributions of symptoms, partner responses to patient symptoms, and relationship satisfaction. Fatigue in partners of patients with CFS was compared with fatigue in age- and gender-matched controls from the Dutch population. Associations between partners' fatigue severity and other partner-related factors were determined. In a subgroup of 760 CFS patients who completed CBT, logistic regression analyses were used to identify partner-related baseline predictors for treatment outcome (fatigue severity, functional impairment). ResultsPartners' fatigue (M = 21.66, SD 11.60) was significantly lower than in controls (M = 24.58, SD = 11.02) (p < .001) and not related to patients' fatigue (r = −0.02, p = .58). Partners' fatigue was correlated with patients' functional impairment (p = .001), partners' and patients' relationship dissatisfaction, negative partner responses, and partners' and patients' psychological attributions of patient symptoms at baseline (all p < .001). After controlling for patients' baseline fatigue severity and functional impairment, only relationship dissatisfaction as reported by (female) patients significantly predicted worse treatment outcome. For male patients with female partners, higher partners' fatigue severity predicted higher fatigue severity after CBT. ConclusionsFemale partners' fatigue and relationship dissatisfaction as reported by the female patient should be addressed in CBT for CFS, as these factors affect treatment outcome.

Exercise therapy for chronic fatigue syndrome.

Exercise therapy for chronic fatigue syndrome.

Oxygen-Ozone Therapy is an Effective Therapy in Chronic Fatigue Syndrome: Results in 100 Patients

The myalgic encephalomyelitis and the chronic fatigue syndrome (ME/CFS), are described as a multifaceted physical complaint. ME/ CFS patients often suffer for incapacitating fatigue, massive energy crashes after minor exertion (post-exertional malaise – PEM), tenderness, cognitive problems, sleeping disorders and many other neurological, immunological and autonomic symptoms.

The effect of childhood trauma on the response to group cognitive behavioural therapy for chronic fatigue syndrome

Childhood maltreatment (CM) and cognitive emotion regulation strategies (CERSs) may be important in alcohol craving and dependence in alcohol-dependent individuals. The aim of this study was to evaluate direct effects of CM on the subscales of alcohol craving and alcohol dependence and its indirect effects via CERSs in individuals with a diagnosis of alcohol dependence.In a cross-sectional design, 329 alcohol-dependent males completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), and the Beck Depression Inventory-II (BDI-II).Participants with alcohol dependence had early age of onset of alcohol use (mean = 20.78 years), relatively long duration of alcohol use (mean = 11.14 years), and low education (mean = 9.55 years). Indirect effects were observed from CM to the subscales of alcohol craving and dependence only through maladaptive CERSs after adjusting for demographic and clinical factors. No direct effect was observed through CM on the subscales of alcohol craving and dependence.Although drawing causal conclusions from the current research is impossible, the findings suggest that maladaptive CERSs may be a possible mechanism relating CM to alcohol craving and dependence in treatment-seeking alcohol-dependent individuals, while adaptive CERSs may be less important regarding this relation. However, the findings of the current study need longitudinal research.

Prediction of long-term outcome after cognitive behavioral therapy for chronic fatigue syndrome

ObjectiveTo determine which variables predicted long-term outcome after cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS). MethodsA cohort of 511 CFS patients from four different CBT for CFS studies, i.e. two cohort studies and two RCT's. Before treatment, all patients fulfilled the 2003 US CDC criteria for CFS and treated with CBT, were assessed at long-term follow-up, up to 10 years after end of treatment. We tried to predict fatigue severity and physical functioning at follow-up with demographics, cognitive-behavioral perpetuating factors, and CFS characteristics as predictors in linear regression analyses. Logistic regression analysis was used to explore significant predictors of fatigue scores within normal limits at long-term follow-up. ResultsLower fatigue severity at long-term follow-up was predicted by a shorter duration of CFS symptoms and lower fatigue levels at baseline, and lower frustration in response to fatigue and lower fatigue levels directly post-treatment. Fatigue scores within normal limits at follow-up was predicted by lower fatigue severity and lower levels of frustration in response to fatigue, both assessed directly post-treatment. Better physical functioning at follow-up was predicted by higher sense of control over fatigue, better physical functioning at post-treatment, and being younger at baseline. In some of the additional analysis pain at baseline also predicted physical functioning at follow-up. ConclusionThe finding that lower fatigue severity and higher physical functioning at long-term follow-up were positively associated with its outcomes at post-treatment underline the importance of fully maximizing the positive effects of CBT for the sustainment of outcomes. Furthermore, augmenting sense of control and starting treatment sooner after diagnosing CFS could positively influence long-term outcome. Interventions aimed at pain management deserve more attention in research.

Jin\u2019s three-needle acupuncture technique for chronic fatigue syndrome: a study protocol for a multicentre, randomized, controlled trial

BackgroundWith an unclear pathomechanism, no confirmed treatment regimen has been established for chronic fatigue syndrome (CFS). Acupuncture is applied as an alternative therapy for CFS. As a kind of acupuncture therapy, Jin’s three-needle acupuncture (JTN) has been applied to treat CFS. However, few large-sample randomised controlled trials on JTN treatment for CFS have been reported. We designed this study to evaluate the efficacy and safety of JTN treatment for CFS.Method/designThis study is a multicentre, single-blind, randomised controlled trial. Patients who meet the inclusion criteria will be recruited and randomly assigned to either the JTN treatment group or the basic acupuncture group. Both interventions will be conducted for five consecutive days per week and last for 2 weeks. The primary outcome is the effective rate based on the 14-item Fatigue Scale (FS-14) score. Other outcome measures include the Fatigue Assessment Scale (FAI), the Depression Status Inventory (DSI), and the Self-rating Anxiety Scale (SAS). Plasma adrenocorticotropic hormone (ACTH), plasma cortisol, and serum levels of IL-2 and IFN-γ will also be measured in this study. Adverse events will be observed and recorded for the safety evaluation.DiscussionThis study may help to identify the efficacy and safety of JTN acupuncture treatment for CFS.Trial registrationChinese Clinical Trial Registry, ID: ChiCTR-IOR-17011009. Registered on 29 March 2017.

Cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective. Re-analysis of a Cochrane review.

Analysis of the 2008 Cochrane review of cognitive behavioural therapy for chronic fatigue syndrome shows that seven patients with mild chronic fatigue syndrome need to be treated for one to report a small, short-lived subjective improvement of fatigue. This is not matched by an objective improvement of physical fitness or employment and illness benefit status. Most studies in the Cochrane review failed to report on safety or adverse reactions. Patient evidence suggests adverse outcomes in 20 per cent of cases. If a trial of a drug or surgical procedure uncovered a similar high rate, it would be unlikely to be accepted as safe. It is time to downgrade cognitive behavioural therapy to an adjunct support-level therapy, rather than a treatment for chronic fatigue syndrome.

Qigong exercise for chronic fatigue syndrome.

Chronic fatigue syndrome (CFS) is often overlooked, has unclear etiology and no effective cure except some symptomatic treatments. Additionally, most people with CFS do not seek medical attention. Qigong exercise, an ancient Eastern body-mind-spirit practice, has been long practiced in Chinese communities and may powerfully trigger the self-healing process. Using full baseline data (n=1409), the average Hong Kong CFS respondent was found to be female, married, 42.5yo, highly educated and employed full-time, experiencing sleep disturbance (~95%), anxiety (>80%), and depressive symptoms (68%). Here, we summarized our previous studies to evaluate the potential of Qigong as a complementary and alternative therapy for CFS. Two randomized controlled trials were conducted (RCT1 n1=137, RCT2 n2=150). In both trials, extensive online questionnaires allowed individuals with CFS-like illness (i.e., symptoms match CFS, yet without clinical confirmation) to be identified. RCT1 included a 5-week intervention. The intervention in RCT2 was 8weeks. In RCT1 Qigong group had reduced fatigue (P<0.001) and depressive symptoms (P=0.002), and improved telomerase activity (P=0.029). An effective practice regimen was identified (≥3 days/week, at ≥30min/session). Methods were slightly adjusted for RCT2, which replicated RCT1 findings, and further documented improved subjective sleep quality (P=0.008) and adiponectin levels (P<0.05). A significant dose-response relationship was founded. Thus, Qigong exercise should be recognized as a possible standalone therapy and self-management skill in CFS. Strategies are needed to increase motivation for regular practice and to explore its possibility of self-management skill in brain health. Further clarity would come from studies comparing Qigong with other physical exercises.

Exercise therapy for chronic fatigue syndrome (individual patient data)

Exercise therapy for chronic fatigue syndrome (individual patient data)