Is the effect of cognitive behaviour therapy for chronic fatigue syndrome (ME/CFS) moderated by the presence of comorbid depressive symptoms? A meta-analysis of three treatment delivery formats

IF 3.5 2区 医学 Q2 PSYCHIATRY Journal of Psychosomatic Research Pub Date : 2024-06-22 DOI:10.1016/j.jpsychores.2024.111850
T.A. Kuut , L.M. Buffart , A.M.J. Braamse , F. Müller , H. Knoop
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Abstract

Objective

Cognitive behaviour therapy (CBT) for fatigue in chronic fatigue syndrome (ME/CFS) leads to a significant reduction of fatigue and disability and is available in different treatment delivery formats, i.e. internet-based, individual face-to-face and group face-to-face. The aim of this study was to investigate whether moderation of the effects of CBT by clinically relevant depressive symptoms varies between CBT delivery formats.

Methods

Data from six randomised controlled trials (n = 1084 patients) were pooled. Moderation of clinically relevant depressive symptoms (Brief Depression Inventory for Primary Care) in different treatment formats on fatigue severity (Checklist Individual Strength, subscale fatigue severity), functional impairment (Sickness Impact Profile-8) and physical functioning (Short Form-36, subscale physical functioning) was investigated using linear mixed model analyses and interaction tests. Differences in percentages of patients no longer severely fatigued post-CBT were studied by calculating relative risks.

Results

The moderator effect of depressive symptoms on fatigue severity varied by delivery format. In internet-based CBT, ME/CFS patients with depressive symptoms showed less reduction in fatigue, and were more often still severely fatigued post-treatment than patients without depressive symptoms. In individual and group face-to-face CBT, no significant difference in treatment effect on fatigue severity was found between patients with and without depressive symptoms. No moderation was found for the other outcomes.

Conclusion

In internet-based CBT, ME/CFS patients with comorbid depressive symptoms benefit less, making face-to-face CBT currently the first-choice delivery format for these patients. Internet-based CBT should be further developed to improve its effectiveness for ME/CFS patients with depressive symptoms.

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认知行为疗法对慢性疲劳综合征(ME/CFS)的治疗效果是否会受到合并抑郁症状的影响?对三种治疗方式的荟萃分析
目的针对慢性疲劳综合征(ME/CFS)疲劳的认知行为疗法(CBT)可显著减轻疲劳和残疾程度,并有不同的治疗形式,即基于互联网、面对面的个体治疗和面对面的小组治疗。本研究旨在探讨不同的 CBT 治疗方式对临床相关抑郁症状的调节作用是否存在差异。通过线性混合模型分析和交互检验,研究了不同治疗方式中临床相关抑郁症状(初级护理简明抑郁量表)对疲劳严重程度(个人体力检查表,疲劳严重程度分量表)、功能障碍(疾病影响档案-8)和身体功能(短表格-36,身体功能分量表)的调节作用。结果抑郁症状对疲劳严重程度的调节作用因治疗方式而异。与没有抑郁症状的患者相比,有抑郁症状的 ME/CFS 患者在基于互联网的 CBT 治疗中,疲劳程度减轻的程度较低,而且治疗后仍严重疲劳的患者更多。在个人和小组面对面的 CBT 治疗中,有抑郁症状和没有抑郁症状的患者对疲劳严重程度的治疗效果没有明显差异。结论 在基于互联网的CBT中,合并抑郁症状的ME/CFS患者获益较少,因此面对面的CBT目前是这些患者的首选治疗形式。应进一步开发基于互联网的CBT,以提高其对有抑郁症状的ME/CFS患者的疗效。
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来源期刊
Journal of Psychosomatic Research
Journal of Psychosomatic Research 医学-精神病学
CiteScore
7.40
自引率
6.40%
发文量
314
审稿时长
6.2 weeks
期刊介绍: The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.
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