Cognitive behaviour therapy for the chronic fatigue syndrome: a randomised controlled trial

Sharpe, Michael; Hawton, Keith; Simkin, Sue; Surawy, Christina; Hackmann, Ann; Klimes, Ivana; Peto, Tim; Warrell, D. W.; Seagroatt, Valerie

doi:10.1136/bmj.312.7022.22

Cited by 479 publications

(297 citation statements)

References 28 publications

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“…27 Studies suggest physicians tend to default toward prescribing medications with dubious benefits to patients with MUS, even when those patients are not asking for pharmacological treatment. 28 Research indicates that medication, 29,30 cognitive-behavioral therapy, 31 and patient-centered management 32,33 may help relieve MUS, though there are contradictory findings. 34,35 It seems reasonable in a biopsychosociospiritual 9,10 model for physicians to explore all options with the patient, but our results demonstrate that physicians' religious characteristics and specialty will influence which option a physician prefers, and how they interpret the cause of MUS.…”

Section: Discussionmentioning

confidence: 99%

A Spiritual Problem? Primary Care Physicians’ and Psychiatrists’ Interpretations of Medically Unexplained Symptoms

et al. 2012

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BACKGROUND:Patients commonly present to their physicians with medically unexplained symptoms (MUS), and there is no consensus about how physicians should interpret or treat such symptoms. OBJECTIVE: To examine how variations in physicians' interpretations of MUS are associated with physicians' religious characteristics and with physician specialty (primary care vs. psychiatry). DESIGN AND PARTICIPANTS: A national survey of a stratified random sample of 1,504 primary care physicians and 512 psychiatrists in 2009-2010. MAIN MEASURES: The extent to which physicians believe MUS reflect a root problem that is spiritual in nature or result from conditions that scientific research will eventually explain, and whether such patients would benefit from attention to their relationships, attention to their spiritual life, taking medications, and/or treatment by physicians. KEY RESULTS: Response rate was 63 % (1,208/ 1,909). More religious/spiritual physicians were more likely to believe that MUS reflect a spiritual problem (55 % for high vs. 24 % for low spirituality; OR=2.8, 1.7-4.5) and that these patients would benefit from paying attention to their spiritual life (79 % for high vs. 55 % for low spirituality; OR=3.1, 1.8-5.3). Psychiatrists were more likely to believe that scientific research will one day explain MUS (66 % vs. 52 %; OR= 1.9, 1.4-2.5) and that these symptoms will improve with treatment by a physician (54 % vs. 35 %; OR=2.4, 1.8-3.3). They were less likely to believe that MUS reflect a spiritual problem (23 % vs. 38 %; OR=0.5, 0.4-0.8). CONCLUSIONS: Physicians' interpretations of MUS vary widely, depending in part on physicians' religious characteristics and specialty. One in three physicians believes that patients with MUS have root problems that are spiritual in nature. Physicians who are more religious or spiritual are more likely to think of MUS as stemming from spiritual concerns. Psychiatrists are more optimistic that these patients will get better with treatment by physicians.

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Section: Discussionmentioning

confidence: 99%

A Spiritual Problem? Primary Care Physicians’ and Psychiatrists’ Interpretations of Medically Unexplained Symptoms

et al. 2012

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“…With regard to successful behavioral interventions in CFS, we agree that outcomes are rarely confirmed with more objective measures, such as actigraphy (which does not improve with the treatment) [3] or the 6-min walk test which sometimes shows increased fitness [4] and sometimes not.…”

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confidence: 87%

Authors’ response to commentary by Twisk

2014

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“…Burtons oppsummering er, at pasienter med 'ubestemte' helseplager har komplekse adaptive systemer, der kognitive og psykologiske prosesser samvirker med hverandre og med omgivelsene (Burton 2003). Kognitiv terapi-reaEribuering I en rekke randomisterte kontrollerte forsøk er det vist god effekt av kognitiv atferdsterapi (cognitive behavioral therapy -CBT) ved somatisering og 'ubestemte' helseplager (Speckens, van Hemert et al 1995;Sharpe, Hawton et al 1996;Deale, Chalder et al 1997;McLeod, Budd et al 1997). Slike behandlingsstrategier er også brukt av fagfolk, som ikke bruker en psykologisk forklaringsmodell (Mayou, Bass et al 1995).…”

Section: Biopsykologien -Exit Høna Og Eggetunclassified

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Malterud¹

2005

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Cognitive behaviour therapy for the chronic fatigue syndrome: a randomised controlled trial

Abstract: Adding cognitive behaviour therapy to the medical care of patients with the chronic fatigue syndrome is acceptable to patients and leads to a sustained reduction in functional impairment.

Cited by 479 publications

References 28 publications

A Spiritual Problem? Primary Care Physicians’ and Psychiatrists’ Interpretations of Medically Unexplained Symptoms

A Spiritual Problem? Primary Care Physicians’ and Psychiatrists’ Interpretations of Medically Unexplained Symptoms

Authors’ response to commentary by Twisk

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