Een nieuwe studie van pleitbezorgers van de (bio)psychosociale gedachtengoed toont aan:
Volgens de onderzoekers is "verbetering" m.b.tv. CGT/GET te voorspellen op basis van psycho-
sociale factoren. Maar als we die stellingname eens nader onderzoeken, blijft er weinig van over.
Als we "herstel" definiëren op basis van het niet meer voldoen aan de CVS- of Oxford-criteria, blijkt dat
"herstel" niet gerelateerd is aan catastroferen, "alles-of-niets gedrag" of andere psychosociale factoren.
Als we "herstel" definiëren in termen van "je veel beter voelen" blijkt dat
"ongezonde overtuigingen m.b.t. emoties" (emoties niet uiten) en depressie verbetering voorspellen.
Het eerste is, gelet op de wijze waarop patiënten behandeld worden vanuit het psychosociale "perspectief"
(ziekte het gevolg van "onbehulpzame gedachten") en de maatschappij verklaarbaar,
het feit dat CGT/GET niet helpt als patiënten depressief zijn, lijkt me tegen CGT/GET pleitten...
De mate van invaliditeit was de enige factor die "herstel" in termen van vermoeidheid voorspelde,
terwijl de leeftijd de mate van herstel in termen van fysieke beperkingen "bepaalde".
Case closed, zou je zo zeggen, maar ja, de onderzoekers hebben daar heel andere ideeën over,
getuige de "uitsmijter":
[T]he number of sessions may need to be increased to facilitate a full recovery.
Vrij vertaald als de hamer niet werkt, dan hamer je gewoon vaker.
Relevante citaten uit het uitgebreide studieverslag:
While
72.2% met the Oxford criteria for CFS at pre-treatment assessment,
53.1% did so at the 6-month follow-up (Pearson chi square = 19.5, df = 1, p < 0.001).
Likewise, chi-square revealed
a significant reduction
in prevalence
from 52.6% of the participants meeting the CDC criteria
at the pre-treatment assessment
to 37.5%
at the 6-month follow-up
(Pearson chi square = 16.8, df = 1, p < 0.001).
...
Recovery was defined as
no longer meeting
either the CDC-criteria or the Oxford criteria.
...
[T]he following variables were associated with a reduced odds for recovery:
disability in terms of work and social adjustment (WSAS),
high levels of "catastrophizing" (CBRQ) and
increased symptoms of depression (HADS-D).
These significant predictors were included in the multivariate logistic regression analysis.
Additionally, the CBRQ subscale "All or nothing behaviour"
was included in the multivariate analysis as it had a p-value of below 0.1.
None of these significant results from the univariate analysis
remained significant in the multivariate analysis.
Prevalence and predictors of recovery from chronic fatigue syndrome in a routine clinical practice.
Behav Res Ther. 2014 Aug 26;63C:1-8. doi: 10.1016/j.brat.2014.08.013.
Flo E, Chalder T.
Abstract
Cognitive behavioural therapy (CBT)
is one of the treatments of choice
for patients with chronic fatigue syndrome (CFS).
However,
the factors
that predict recovery
are unknown.
The objective of this study was
to ascertain
the recovery rate
among CFS patients
receiving CBT
in routine practice and
to explore
possible predictors of
recovery.
Recovery was defined as
no longer meeting
Oxford or CDC criteria for CFS
measured at 6 months follow-up.
A composite score
representing
full recovery
additionally included
the perception of improvement, and
normal population levels
of fatigue and
of physical functioning.
Logistic regression was used
to examine
predictors of recovery.
Predictors included
age,
gender,
cognitive and behavioural responses to symptoms,
work and social adjustment,
beliefs about emotions,
perfectionism,
anxiety and
depression
at baseline.
At 6 months follow-up
37.5% of the patients
no longer met
either the Oxford
or the CDC criteria for CFS
while
18.3% were fully recovered.
Multivariate analyses showed that
worse scores on
the work and social adjustment scale,
unhelpful beliefs about emotions,
high levels of depression and
older age
were associated with
reduced odds for recovery.
Recovery rates in this routine practice
were comparable to
previous RCTs.
There was
a wide spectrum of
significant predictors for recovery.
KEYWORDS:
Chronic fatigue syndrome; Cognitive behavioural therapy; Follow-up; Longitudinal; Recovery
PMID: 25222752
Highlights:
- This study investigates recovery from CFS in a routine practice.
- Approximately 18% of people with CFS recover after CBT.
- CBT in routine practice demonstrated recovery rates akin to RCTs.
http://www.sciencedirect.com/science/article/pii/S0005796714001429
http://ac.els-cdn.com/S0005796714001429/1-s2.0-S0005796714001429-main.pdf?
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&acdnat=1411054774_ffe5fc0514dfab6292d1f7db5480d1e2
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