Bent, Georgina C; (1998) The relationship between psychosocial variables and treatment outcome in chronic fatigue syndrome. Doctoral thesis (D.Clin.Psy.), UCL (University College London).

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Abstract

Objective: To evaluate the efficacy of cognitive behaviour therapy (CBT) for treating chronic fatigue syndrome (CFS) aid the relationship between treatment outcome and psychosocial variables including stressful life-events, social support, illness attributions and perfectionism. Design: Retrospective, uncontrolled study based on CFS patients' responses to questionnaires filled in before and after CBT treatmert, assessing outcome and psychosocial variables. Setting: Specialist tertiary referral outpatient CFS clinic. Subjects: Eighty-six CFS patients assessed between April '94 and May '96, who subsequently completed a course of CBT. Results: Thirtv-five per cent and 33 per cent of patients who completed CBT treatment achieved a clinically significant improvement on a measure of functional impairment at 6 month and 1 year follow-ups respectively. There was considerable evidence for a relationship between the number and severity of stressful life-events experienced since the start of treatment and treatment outcome at 1 year follow-up. There was no evidence for a relationship between other psychosocial variables- social support, perfectionism and illness attributions - and treatment outcome. Conclusions: CBT treatment in routine clinical practice does not lead to clinically significant improvements in as many patients as was found in previous CBT clinical trials based on a more selected group of CFS sufferers. Further prospective research is needed, to assess whether stressful life-events, social support, illness attributions and perfectionism are predictive of treatment outcome, using a larger sample size and measures of these psychosocial variables at pre-treatment.

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