CGT/GET, het "wondermiddel voor "CVS", leidt, volgens de onderzoekers van PACE zelf,
tot "herstel" bij 22% van mensen met "chronische vermoeidheid"
(mensen met "CVS" volgens de
Oxford-criteria of
aanpaste Londen-criteria, blz, 188).
Aangezien pacing en standaard-medische zorg tot "herstel" leiden bij 8% resp. 7%,
zijn CGT en GET "maar liefst" 14-15% "effectiever" in "CVS"
en dan alleen nog maar in "subjectieve termen" van "vermoeidheid" etc.
Zoals eerder door anderen feitelijk onderbouwd, zijn CGT en GET,
zowel in subjectieve als in objectieve termen, ineffectief
zelfs voor patiλnten met "CVS"
(klik hier, hier,
hier en hier).
Tabellen uit het studierapport die de "herstel"percentages samenvatten:
Table 1.
Participants, % (n/total), meeting criteria for recovery
|
|
APT
|
CBT
|
GET
|
SMC
|
|
Cumulative criteria for trial recovery
|
|
|
|
|
|
|
Both CFQ and SF-36-PF
in normal range
|
16 (25/153)
|
30 (44/148)
|
28 (43/154)
|
15 (22/152)
|
|
|
And Oxford criteria not met
|
15 (23/149)
|
28 (40/143)
|
28 (41/144)
|
14 (21/150)
|
|
|
And CGI 1 or 2 (95% CI)
|
8 (12/149)
|
22 (32/143)
|
22 (32/143)
|
7 (11/150)
|
|
|
|
(414)
|
(1630)
|
(1630)
|
(413)
|
|
|
|
Additional criteria for clinical recovery
|
|
|
And International (CDC) CFS criteria not met
|
8 (12/149)
|
22 (32/143)
|
22 (32/143)
|
7 (11/149)
|
|
|
And London ME criteria not met (95% CI)
|
8 (12/147)
(414)
|
21 (29/139)
(1429)
|
21 (29/138)
(1529)
|
7 (11/147)
(413)
|
Table 2.
Composite criteria for trial recovery in subgroups
meeting alternative definitions of CFS or ME at baseline
|
|
APT
|
CBT
|
GET
|
SMC
|
|
All participants
|
8 (12/149)
|
22 (32/143)
|
22 (32/143)
|
7 (11/150)
|
|
International (CDC) criteria
|
9 (9/102)
|
19 (17/89)
|
22 (20/93)
|
6 (6/98)
|
|
London ME criteria
|
11 (8/75)
|
21 (15/70)
|
21 (16/75)
|
10 (7/73)
|
Recovery from chronic fatigue syndrome after treatments given in the PACE trial
Psychological Medicine. 2013. doi:10.1017/S0O3329171300002O.
P. D. White, K. Goldsmith, A. L. ]ohnson, T. Chalder and M. Sharpe;
PACE Trial Management Group
Background.
A multi-centre, four-arm trial (the PACE trial) found that
rehabilitative cognitive behaviour therapy (CBT) and
graded exercise therapy (GET)
were more effective treatments
for chronic fatigue syndrome (CFS)
than specialist medical care (SMC) alone,
when each was added to SMC, and
more effective than
adaptive pacing therapy (APT)
when added to SMC.
In this study we compared
how many participants recovered
after each treatment.
Method.
We defined recovery operationally
using multiple criteria, and
compared the proportions of participants
meeting each individual criterion
along with two composite criteria,
defined as
(a) recovery in the context of the trial and
(b) clinical recovery from the current episode of the illness,
however defined, 52 weeks after randomization.
We used logistic regression modelling to compare treatments.
Results.
The percentages (number/total) meeting trial criteria for recovery were
22% (32/143) after CBT,
22% (32/143) after GET,
8% (12/149) after APT and
7% (11/ 150) after SMC.
Similar proportions met criteria for clinical recovery.
The odds ratio (OR) for trial recovery
after CBT was 3.36 [95 % confidence interval (CI) 1.646.88] and
for GET 3.38 (95% Cl 1.656.93),
when compared to APT,
and after CBT 3.69 (95% CI 1.777.69) and
GET 3.71 (95% CI 1.78-7.74),
when compared to SMC (p values <0.001 for all comparisons).
There was no significant difference between APT and SMC.
Similar proportions recovered
in trial subgroups meeting different definitions of the illness.
Conclusions.
This study confirms that
recovery from CFS is possible, and
that CBT and GET are the therapies most likely to lead to recovery.
Key words:
Chronic fatigue syndrome, cognitive behaviour therapy,
graded exercise therapy, randomized control trial, recovery.
http://journals.cambridge.org/images/fileUpload/documents/White_PSM_Paper_Jan13.pdf
|
