Cognitive-behaviour therapy for chronic fatigue syndrome: Comparison of outcomes within and outside the confines of a randomised controlled trial
Cognitive-behaviour therapy for chronic fatigue syndrome: Comparison of outcomes within and outside the confines of a randomised controlled trial
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DOI：
10.1016/j.brat.2006.08.019
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发表时间：
2007-06-01
影响因子：
4.1
通讯作者：
Chalder, Trudie
中科院分区：
文献类型：
--
作者：
Quarmby, Louise;Rimes, Katharine A.;Chalder, Trudie
认知行为疗法（CBT）在随机对照试验（RCT）中的结果很少与常规临床实践中的结果进行比较。以CBT治疗慢性疲劳综合征（CFS）为例，我们评估了成功RCT的结果，并与常规实践中在相同环境中给予相同治疗的结果进行了比较。将接受CBT治疗CFS的患者（N = 30）和接受CBT治疗CFS的患者（N = 384）的疲劳和社会适应评分进行比较，RCT的结果上级优于常规临床实践。在治疗前和6个月随访期间，RCT显示与常规治疗相比，疲劳减少更大，社会适应改善更大。治疗期间两组疲劳评分的变化相似，但在RCT中，治疗后和随访之间的变化更大。RCT的上级结果的潜在原因包括患者选择、治疗师因素和手动治疗方案的使用。从业人员需要特别注意预防复发，并确保充分的后续行动，除了鼓励患者继续与认知行为策略，一旦治疗结束。(c)2006爱思唯尔有限公司保留所有权利。
Outcomes for cognitive-behaviour therapy (CBT) in randomised controlled trials (RCTs) have rarely been compared to those in routine clinical practice. Taking the case of CBT for chronic fatigue syndrome (CFS), we evaluated the results of a successful RCT against those of the same treatment given in the same setting as part of routine practice. Fatigue and social adjustment scores were compared for patients who received CBT for CFS as part of a RCT (N = 30) and patients who received CBT as part of everyday clinical practice (N = 384).The results in the RCT were superior to those in routine clinical practice. Between pre-treatment and 6-month follow-up, the RCT showed a larger reduction in fatigue and greater improvement in social adjustment than those in routine treatment. The changes in fatigue scores were similar for both groups during treatment but were greater in the RCT between post-treatment and follow-up.Potential reasons for the superior results of the RCT include patient selection, therapist factors and the use of a manualised treatment protocol. Practitioners need to pay particular attention to relapse prevention and ensuring adequate follow-up in addition to encouraging patients to continue with cognitive-behavioural strategies once treatment has ended. (c) 2006 Elsevier Ltd. All rights reserved.