Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: Long-term follow-up of an RCT
Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: Long-term follow-up of an RCT
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DOI：
10.1016/j.brat.2012.08.005
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发表时间：
2012-11-01
影响因子：
4.1
通讯作者：
Rimes, Katharine A.
中科院分区：
文献类型：
--
作者：
Lloyd, Samantha;Chalder, Trudie;Rimes, Katharine A.
本研究的目的是比较以家庭为中心的认知行为疗法(CBT)和心理教育在改善慢性疲劳综合征(CFS)青少年的出勤率和其他次要结果方面的长期疗效。对一项随机对照试验进行了24个月的随访。参与者接受了13次为期一小时的家庭CBT或四次为期一小时的心理教育。44名参与者参与了后续研究。在24个月时，CBT组和心理教育组的参与者报告至少70%的出勤率(主要结果)的比例分别为90%和84%：两组之间的差异没有统计学意义(OR=1.29，p=0.80)。根据包括疲劳和出勤率的定义，以家庭为中心的CBT组的青少年康复比例为79%，而心理教育组的康复比例为%。这一差异无统计学意义(Fisher‘s Exact检验，p=0.34)。根据青少年(F=6.49，P=0.02)和父母(F=4.52，P=0.04)的报告，在24个月的随访中，以家庭为中心的CBT与心理教育相比，显著改善了情绪和行为适应。在6个月到24个月的随访期间，两组的损害都显著减少，在这段时间内，两组之间的改善没有显著差异。之前观察到的其他次要结果在6个月的随访中的收益在24个月的随访中保持不变，没有进一步的显着改善或组内改善的差异。总而言之，接受了以家庭为中心的CBT和心理教育的CFS青少年所取得的进展一般继续或在两年的随访中保持不变。例外情况是，以家庭为中心的CBT与情绪和行为困难的持续改善有关，而心理教育与6至24个月随访期间这些结果的恶化有关。(C)2012爱思唯尔有限公司。保留所有权利。
The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group: the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with deterioration in these outcomes between six and 24-month follow-up. (C) 2012 Elsevier Ltd. All rights reserved.