Salivary cortisol output before and after cognitive behavioural therapy for chronic fatigue syndrome

2009 ◽  
Vol 115 (1-2) ◽  
pp. 280-286 ◽  
Author(s):  
Amanda D.L. Roberts ◽  
Andrew S. Papadopoulos ◽  
Simon Wessely ◽  
Trudie Chalder ◽  
Anthony J. Cleare
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Salivary Cortisol ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Before And After

Does hypocortisolism predict a poor response to cognitive behavioural therapy in chronic fatigue syndrome?

2009 ◽  
Vol 40 (3) ◽  
pp. 515-522 ◽  
Author(s):  
A. D. L. Roberts ◽  
M.-L. Charler ◽  
A. Papadopoulos ◽  
S. Wessely ◽  
T. Chalder ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Psychotropic Medication ◽  
Salivary Cortisol ◽  
Poor Response ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Free Cortisol

BackgroundThere is evidence that patients with chronic fatigue syndrome (CFS) have mild hypocortisolism. The clinical significance of this is unclear. We aimed to determine whether hypocortisolism exerted any effect on the response of CFS to cognitive behavioural therapy (CBT).MethodWe measured 24-h urinary free cortisol (UFC) in 84 patients with Centers for Disease Control and Prevention (CDC)-defined CFS (of whom 64 were free from psychotropic medication) who then received CBT in a specialist, tertiary out-patient clinic as part of their usual clinical care. We also measured salivary cortisol output from 0800 to 2000 h in a subsample of 56 psychotropic medication-free patients.ResultsOverall, 39% of patients responded to CBT after 6 months of treatment. Lower 24-h UFC output was associated with a poorer response to CBT but only in psychotropic medication-free patients. A flattened diurnal profile of salivary cortisol was also associated with a poor response to CBT.ConclusionsLow cortisol is of clinical relevance in CFS, as it is associated with a poorer response to CBT. Hypocortisolism could be one of several maintaining factors that interact in the persistence of CFS.

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

2020 ◽  
Vol 113 (10) ◽  
pp. 394-402
Author(s):  
James Adamson ◽  
Sheila Ali ◽  
Alastair Santhouse ◽  
Simon Wessely ◽  
Trudie Chalder
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Social Adjustment ◽  
Physical Functioning ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Uk

Objectives Cognitive 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. Design Using 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. Setting Data were available for 995 patients receiving cognitive behavioural therapy for chronic fatigue syndrome at an outpatient clinic in the UK. Participants Participants were referred consecutively to a specialist unit for chronic fatigue or chronic fatigue syndrome. Main outcome measures Patients 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. Results Patients’ 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). Conclusions Patients’ 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.

White matter changes following cognitive behavioural therapy in patients with chronic fatigue syndrome

NeuroImage ◽  
2009 ◽  
Vol 47 ◽  
pp. S55
Author(s):  
J. Scholz ◽  
F.P. De Lange ◽  
J.W. van der Meer ◽  
G. Bleijenberg ◽  
P. Hagoort ◽  
...  
Keyword(s):  
White Matter ◽  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
White Matter Changes ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural

scholarly journals Effect of psychiatric disorders on outcome of cognitive-behavioural therapy for chronic fatigue syndrome

2005 ◽  
Vol 187 (2) ◽  
pp. 184-185 ◽  
Author(s):  
Judith Prins ◽  
Gijs Bleijenberg ◽  
Eufride Klein Rouweler ◽  
Jos Van Der Meer
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychiatric Disorders ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Psychiatric Diagnoses ◽  
Psychiatric Interview ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
The Impact

SummaryPsychiatric disorders have been associated with poor outcome in individuals with chronic fatigue syndrome (CFS). This study examines the impact of psychiatric disorders on outcome of cognitive-behavioural therapy (CBT). Psychiatric diagnoses were assessed with a structured psychiatric interview in a CBT trial of 270 people with CFS. Lifetime and current psychiatric disorders were found in 50 and 32% respectively. No significant differences in fatigue severity and functional impairment following treatment were found between participants with and without psychiatric diagnoses.

scholarly journals RESPONSE TO ADAMSON ET AL. (2020): “COGNITIVE BEHAVIOURAL THERAPY FOR CHRONIC FATIGUE AND CHRONIC FATIGUE SYNDROME: OUTCOMES FROM A SPECIALIST CLINIC IN THE UK”

2021 ◽  
Author(s):  
Brian Hughes ◽  
David Tuller
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Scientific Publication ◽  
Behavioural Therapy ◽  
Control Group ◽  
Fatigue Syndrome ◽  
Sample Attrition ◽  
Cognitive Behavioural ◽  
The Uk

In this review, we consider the paper by Adamson et al., published in the October 2020 issue of the Journal of the Royal Society of Medicine. The authors interpret their data as revealing significant improvements following cognitive behavioural therapy in a large sample of patients with chronic fatigue syndrome and chronic fatigue. Overall, the research is hampered by several fundamental methodological limitations that are not acknowledged sufficiently, or at all, by the authors. These include: (a) sampling ambiguity; (b) weak measurement; (c) survivor bias; (d) missing data; and (e) lack of a control group. In particular, the study is critically hampered by sample attrition, rendering the presentation of statements in the Abstract misleading with regard to points of fact, and, in our view, urgently requiring a formal published correction. In light of the fact that the paper was approved by multiple peer-reviewers and editors, we reflect on what its publication can teach us about the nature of contemporary scientific publication practices.

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