scholarly journals Work Rehabilitation and Medical Retirement for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients. A Review and Appraisal of Diagnostic Strategies

Diagnostics ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 124 ◽  
Author(s):  
Vink ◽  
Vink-Niese
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Sick Leave ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Full Time ◽  
Fatigue Syndrome ◽  
Number Of Patients ◽  
Graded Exercise Therapy ◽  
Retirement Policy

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome leads to severe functional impairment and work disability in a considerable number of patients. The majority of patients who manage to continue or return to work, work part-time instead of full time in a physically less demanding job. The prognosis in terms of returning to work is poor if patients have been on long-term sick leave for more than two to three years. Being older and more ill when falling ill are associated with a worse employment outcome. Cognitive behavioural therapy and graded exercise therapy do not restore the ability to work. Consequently, many patients will eventually be medically retired depending on the requirements of the retirement policy, the progress that has been made since they have fallen ill in combination with the severity of their impairments compared to the sort of work they do or are offered to do. However, there is one thing that occupational health physicians and other doctors can do to try and prevent chronic and severe incapacity in the absence of effective treatments. Patients who are given a period of enforced rest from the onset, have the best prognosis. Moreover, those who work or go back to work should not be forced to do more than they can to try and prevent relapses, long-term sick leave and medical retirement.

Myalgic encephalomyelitis/chronic fatigue syndrome patients’ reports of symptom changes following cognitive behavioural therapy, graded exercise therapy and pacing treatments: Analysis of a primary survey compared with secondary surveys

2017 ◽  
Vol 24 (10) ◽  
pp. 1318-1333 ◽  
Author(s):  
Keith Geraghty ◽  
Mark Hann ◽  
Stoyan Kurtev
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Exercise Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Myalgic Encephalomyelitis ◽  
Fatigue Syndrome ◽  
Cognitive Behavioural ◽  
Graded Exercise Therapy ◽  
Graded Exercise

Cognitive behavioural therapy and graded exercise therapy are promoted as evidence-based treatments for myalgic encephalomyelitis/chronic fatigue syndrome. This article explores patients’ symptom responses following these treatments versus pacing therapy, an approach favoured by many sufferers. We analyse data from a large cross-sectional patient survey ( n = 1428) and compare our findings with those from comparable patient surveys ( n = 16,665), using a mix of descriptive statistics and regression analysis modelling. Findings from analysis of primary and secondary surveys suggest that cognitive behavioural therapy is of benefit to a small percentage of patients (8%–35%), graded exercise therapy brings about large negative responses in patients (54%–74%), while pacing is the most favoured treatment with the lowest negative response rate and the highest reported benefit (44%–82%).

scholarly journals Graded exercise therapy for myalgic encephalomyelitis/chronic fatigue syndrome is not effective and unsafe. Re-analysis of a Cochrane review

2018 ◽  
Vol 5 (2) ◽  
pp. 205510291880518 ◽  
Author(s):  
Mark Vink ◽  
Alexandra Vink-Niese
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Exercise Therapy ◽  
Cochrane Review ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Sufficient Evidence ◽  
Fatigue Syndrome ◽  
Graded Exercise Therapy ◽  
Graded Exercise ◽  
Objective Outcomes

The analysis of the 2017 Cochrane review reveals flaws, which means that contrary to its findings, there is no evidence that graded exercise therapy is effective. Because of the failure to report harms adequately in the trials covered by the review, it cannot be said that graded exercise therapy is safe. The analysis of the objective outcomes in the trials provides sufficient evidence to conclude that graded exercise therapy is an ineffective treatment for myalgic encephalomyelitis/chronic fatigue syndrome.

Recovery from refractory chronic fatigue syndrome with CBT and modafinil

2021 ◽  
Vol 14 (3) ◽  
pp. e240283
Author(s):  
Himanshu Garg ◽  
Maggie Douglas ◽  
Gordon Douglas Turkington ◽  
Douglas Turkington
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Full Time ◽  
Liaison Psychiatry ◽  
Permanent Disability ◽  
Fatigue Syndrome ◽  
Graded Exercise Therapy ◽  
Evidence Based Treatments ◽  
Social Recovery

Many patients with chronic fatigue syndrome (CFS) fail to derive benefit from evidence-based treatments such as cognitive–behavioural therapy (CBT) and graded exercise therapy leading to permanent disability. To discover whether a repeat prescription of modafinil might potentiate the benefits of CBT leading to social recovery as defined by 2 or more point improvement in energy and muscular pain/concentration and return to work or full-time training. Three patients with treatment-resistant CFS (mean duration 17.66 years) treated with modafinil and CBT in a Liaison Psychiatry clinic were retrospectively reviewed. Progress was reviewed at baseline, 4–6 months and 10–24 months. Patients rated their fatigue, pain and concentration using 10-point Likert scales. 2/3 achieved clinically meaningful improvements in energy and pain/concentration and 3/3 achieved social recovery. Modafinil, when prescribed over the medium term, would appear to be a potentially useful potentiating agent when added to CBT.

Monitoring treatment harm in myalgic encephalomyelitis/chronic fatigue syndrome: A freedom-of-information study of National Health Service specialist centres in England

2019 ◽  
pp. 135910531985453
Author(s):  
Graham McPhee ◽  
Adrian Baldwin ◽  
Tom Kindlon ◽  
Brian M Hughes
Keyword(s):  
National Health Service ◽  
Chronic Fatigue Syndrome ◽  
Health Service ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Freedom Of Information ◽  
Fatigue Syndrome ◽  
Graded Exercise Therapy ◽  
Graded Exercise ◽  
Related Harm

The use of graded exercise therapy and cognitive behavioural therapy for myalgic encephalomyelitis/chronic fatigue syndrome has attracted considerable controversy. This controversy relates not only to the disputed evidence for treatment efficacy but also to widespread reports from patients that graded exercise therapy, in particular, has caused them harm. We surveyed the National Health Service–affiliated myalgic encephalomyelitis/chronic fatigue syndrome specialist clinics in England to assess how harms following treatment are detected and to examine how patients are warned about the potential for harms. We sent 57 clinics standardised information requests under the United Kingdom’s Freedom of Information Act. Data were received from 38 clinics. Clinics were highly inconsistent in their approaches to the issue of treatment-related harm. They placed little or no focus on the potential for treatment-related harm in their written information for patients and for staff. Furthermore, no clinic reported any cases of treatment-related harm, despite acknowledging that many patients dropped out of treatment. In light of these findings, we recommend that clinics develop standardised protocols for anticipating, recording, and remedying harms, and that these protocols allow for therapies to be discontinued immediately whenever harm is identified.

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