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Efficacy and Acceptance of Cognitive Behavioral Therapy in Adults with Chronic Fatigue Syndrome: A Meta-analysis

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Názov: Efficacy and Acceptance of Cognitive Behavioral Therapy in Adults with Chronic Fatigue Syndrome: A Meta-analysis
Autori: Frederic Maas genannt Bermpohl, Ann-Cathrin Kucharczyk-Bodenburg, Alexandra Martin
Zdroj: Int J Behav Med
Informácie o vydavateľovi: Springer Science and Business Media LLC, 2024.
Rok vydania: 2024
Predmety: Adult, Meta-Analyses and Reviews, Chronic fatigue syndrome, Adherence, Randomized Controlled Trials as Topic [MeSH], Depression/therapy [MeSH], Patient Acceptance of Health Care/statistics, Fatigue Syndrome, Chronic/therapy [MeSH], Depression/psychology [MeSH], Anxiety/psychology [MeSH], Treatment evaluation [Cognitive Behavioral Therapy/methods [MeSH], Drop-out, Adult [MeSH], Fatigue Syndrome, Chronic/psychology [MeSH], Humans [MeSH], Treatment Outcome [MeSH], Myalgic encephalomyelitis, Patient Acceptance of Health Care/psychology [MeSH], Anxiety/therapy [MeSH], Special Issue], Fatigue Syndrome, Chronic, Cognitive Behavioral Therapy, Special Issue: Meta-Analyses and Reviews, Depression, 05 social sciences, Patient Acceptance of Health Care, Anxiety, 3. Good health, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, Humans, 0501 psychology and cognitive sciences, Randomized Controlled Trials as Topic
Popis: Background The systematic aggregation of research on cognitive behavioral therapy (CBT) in chronic fatigue syndrome (CFS) needs an update. Although meta-analyses evaluating interventions typically focus on symptom reduction, they should also consider indicators of treatment acceptability, e.g., drop-out rates. Methods Randomized controlled trials (RCTs) investigating CBT in adults with CFS compared to inactive and non-specific control groups were included. First, efficacy was examined, considering fatigue, depression, anxiety, and perceived health. Secondly, drop-out rates through different trial stages were analyzed: Non-completion of all mandatory sessions, drop-out (primary study definition), treatment refusal (non-starters), and average of sessions completed. Result We included 15 RCTs with 2015 participants. CBT was more effective than controls in fatigue (g = -0.52, 95%CI -0.69 to -0.35), perceived health, depression, and anxiety at post-treatment. At long-term follow-up the effects were maintained for fatigue and anxiety. Rates of non-completion (22%, 95%CI 3–71), drop-out (15%, 95%CI 9–25), and treatment refusal (7%, 95%CI 3–15) were relatively low, with a high average proportion of sessions completed. Total time of therapy moderated the effect on fatigue, while the number of sessions moderated the effect on perceived health. Fatigue severity influenced adherence. Conclusion The results indicate that CBT for CFS is effective in reducing fatigue, fatigue related impairment, and severity of depression and anxiety. Conclusions on efficacy at follow-ups are still limited. However, adherence is high in CBT. The results may help to inform clinical practice. Future research should focus on examining the maintenance of effects, while also emphasizing the importance of treatment acceptance.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1532-7558
1070-5503
DOI: 10.1007/s12529-023-10254-2
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38228869
https://repository.publisso.de/resource/frl:6508482
Rights: CC BY
Prístupové číslo: edsair.doi.dedup.....d4f95f15bd9d8854994ac398833605f9
Databáza: OpenAIRE
Popis
Abstrakt:Background The systematic aggregation of research on cognitive behavioral therapy (CBT) in chronic fatigue syndrome (CFS) needs an update. Although meta-analyses evaluating interventions typically focus on symptom reduction, they should also consider indicators of treatment acceptability, e.g., drop-out rates. Methods Randomized controlled trials (RCTs) investigating CBT in adults with CFS compared to inactive and non-specific control groups were included. First, efficacy was examined, considering fatigue, depression, anxiety, and perceived health. Secondly, drop-out rates through different trial stages were analyzed: Non-completion of all mandatory sessions, drop-out (primary study definition), treatment refusal (non-starters), and average of sessions completed. Result We included 15 RCTs with 2015 participants. CBT was more effective than controls in fatigue (g = -0.52, 95%CI -0.69 to -0.35), perceived health, depression, and anxiety at post-treatment. At long-term follow-up the effects were maintained for fatigue and anxiety. Rates of non-completion (22%, 95%CI 3–71), drop-out (15%, 95%CI 9–25), and treatment refusal (7%, 95%CI 3–15) were relatively low, with a high average proportion of sessions completed. Total time of therapy moderated the effect on fatigue, while the number of sessions moderated the effect on perceived health. Fatigue severity influenced adherence. Conclusion The results indicate that CBT for CFS is effective in reducing fatigue, fatigue related impairment, and severity of depression and anxiety. Conclusions on efficacy at follow-ups are still limited. However, adherence is high in CBT. The results may help to inform clinical practice. Future research should focus on examining the maintenance of effects, while also emphasizing the importance of treatment acceptance.
ISSN:15327558
10705503
DOI:10.1007/s12529-023-10254-2