Efficacy of web-based cognitive–behavioural therapy for chronic fatigue syndrome: randomised controlled trial (2018) Knoop

Esther12

Esther12

Senior Member (Voting Rights)
This thread was merged with an earlier thread started before the paper was posted.


I've got no more info that this right now, but am feeling a bit brain-dead. They said that they paper was published yesterday. I've been having trouble with the British Journal of Psychiatry's website, but wasn't able to see it.

Google translate version:

https://translate.google.com/transl...oeidheidssyndroom-is-effectief-en-veilig-.htm
 
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Abstract
Face-to-face cognitive–behavioural therapy (CBT) leads to a reduction of fatigue in chronic fatigue syndrome (CFS).

To test the efficacy of internet-based CBT (iCBT) for adults with CFS.

A total of 240 patients with CFS were randomised to either iCBT with protocol-driven therapist feedback or with therapist feedback on demand, or a waiting list. Primary outcome was fatigue severity assessed with the Checklist Individual Strength (Netherlands Trial Register: NTR4013).

Compared with a waiting list, intention-to-treat (ITT) analysis showed a significant reduction of fatigue for both iCBT conditions (protocol-driven feedback: B = −8.3, 97.5% CI −12.7 to −3.9, P < 0.0001; feedback on demand: B = −7.2, 97.5% CI −11.3 to –3.1, P < 0.0001). No significant differences were found between both iCBT conditions on all outcome measures (P = 0.3–0.9). An exploratory analysis revealed that feedback-on-demand iCBT required less therapist time (mean 4 h 37 min) than iCBT with protocol-driven feedback (mean 6 h 9 min, P < 0.001) and also less than face-to-face CBT as reported in the literature.

Both iCBT conditions are efficacious and time efficient.
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https://www.cambridge.org/core/jour...rolled-trial/5D0DAAB8740D23688778FD2239317101

Also mentioned by the British Journal of Psychiatry's editor in her intro to the issue, where she talks about "the known benefit of face-to-face CBT on fatigue in CFS":

https://www.cambridge.org/core/jour...f-this-issue/2D9FCEB80390DB087AA34633DBD3FFB8

I'd already created a thread on a news article about this article which claims a 40% recovery rate: https://www.s4me.info/threads/2nd-f...et-cbt-paper-cant-find-the-paper-though.2222/
 
It looks like the journal recently switched from being published by the Royal College of Psychiatrists to being published by Cambridge University Press. Apparently Google hasn't caught up yet, though based on the dates on the old site, they only stopped publishing around the new year.
 
This seems to be another nail in the coffin in addition to SMILE. However you do it if you tell patients that the way to get better is to say they are better when asked then they are likely to say they are better, just for a quiet life.

It's a bit like being at a luvvies (stage people) party. You have to ask the host before you approach a new guest what it was they were marvellous in recently and tell them how marvellous they were. Otherwise they look crestfallen.

Edit: the point being that you do not need psychotherapists!!
 
They do say:

A post hoc analysis
showed that objectively assessed physical activity significantly
increased after iCBT. However, this might be an accidental finding,
taking the amount of missing data into account and previous research
that did not find an increase in physical activity following CBT.36
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They have very little on this in the paper though.

They include some data in supplementary materials two, but it includes highlighting and strike-through in a way that makes it look like this is not a final copy:

https://www.cambridge.org/core/jour...778FD2239317101#fndtn-supplementary-materials

Reference 32 is the PACE recovery paper:

First, in line with previous studies this study has shown that a subgroup of patients with CFS were able to reduce their fatigue severity to healthy proportions and reduce their overall impairment and improve psychological well-being.18,32
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Esther12 said:
I've got no more info that this right now, but am feeling a bit brain-dead. They said that they paper was published yesterday. I've been having trouble with the British Journal of Psychiatry's website, but wasn't able to see it.

Google translate version:

https://translate.google.com/transl...oeidheidssyndroom-is-effectief-en-veilig-.htm
Click to expand...
Internet therapy for fatigue syndrome is effective and safe
02-02-2018
Behavioral therapy via the Internet for people with chronic fatigue syndrome (CFS), also known as ME, helps and is safe. This appears from research by the AMC and Radboudumc, which was published yesterday by The British Journal of Psychiatry.

The study of 240 patients with chronic fatigue syndrome shows that patients who follow internet therapy have fewer complaints and limitations. Approximately 40 per cent recovered from the severe fatigue after the treatment. Cognitive behavioral therapy does not lead to an increase in symptoms and has no negative side effects compared with patients who do not receive the therapy.

There is a lot of discussion about the treatment of chronic fatigue syndrome. In the Netherlands 30 thousand to 40 thousand people have this condition. They are constantly tired and are severely limited by their complaints in their daily lives.According to the Dutch guideline for CFS / ME from 2013, cognitive behavioral therapy is the first choice of treatment. Some patient associations, however, claim that behavioral therapy is ineffective and unsafe. A number of people would receive more instead of fewer complaints because of behavioral therapy.

Researchers from the AMC and Radboudumc examined the effectiveness and safety of this form of treatment. They developed an internet version of behavioral therapy. The advantage of this is that patients do not have to travel for their treatment and that the therapist spends less time giving the therapy.

The researchers conclude that behavioral therapy via the internet is safe and effective. They believe that even more CFS / ME patients can benefit from treatment by offering more intensive follow-up therapy to patients who have not improved enough after the internet therapy.
 
Based on the tables, it looks like SF36-PF scores barely changed at all in the CBT patients versus controls. +2 points for one CBT group and +5.8 for the other CBT group. That's pretty much nothing on that scale, and it looks like a lot of people scored lower after therapy in the "protocol-driven feedback" CBT group, since the standard deviation of differences ranges from -3.6 to +8.4.
 
Valentijn said:
Based on the tables, it looks like SF36-PF scores barely changed at all in the CBT patients versus controls. +2 points for one CBT group and +5.8 for the other CBT group. That's pretty much nothing on that scale, and it looks like a lot of people scored lower after therapy in the "protocol-driven feedback" CBT group, since the standard deviation of differences ranges from -3.6 to +8.4.
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This is fake news Valentijn. This is a great, great therapy. More people have made use of this State of the Nation therapy than ever before in history. It is draining the swamp. After this therapy people increased there ability to fill in on line questionnaires about how able they were to fill in on line questionnaires by 1000 per cent, really incredible. Don't knock it.
 
Jonathan Edwards said:
This is fake news Valentijn. This is a great, great therapy. More people have made use of this State of the Nation therapy than ever before in history. It is draining the swamp. After this therapy people increased there ability to fill in on line questionnaires about how able they were to fill in on line questionnaires by 1000 per cent, really incredible. Don't knock it.
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Make Psychobabble Great Again! :D
 
really wish the mea would loudly exit cmrc. it horrified me to learn that they were sending medical students there.

these people are sort of relying on the idea that "some" charities are intransigent little impudent scoundrels who for no reason oppose saintly logical scientific efforts. if mea exits loudly, that argument weakens. afme or whoever remains complicit get isolated.

i wonder if any of these recent papers and articles [not necesasrily this one] are being rushed out to deal with @Nathalie Wright's article in the independent. the key thing about that article is that it is in a major newspaper, and covers the politics in addition to the other stuff, thus providing plausible reasons to the reader why human rights are being violated. this i imagine would be felt as a threat by the bad guys.
 
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Samuel said:
really wish the mea would loudly exit cmrc.

i wonder if any of these recent papers and articles [not necesasrily this one] are being rushed out to deal with @Nathalie Wright's article in the independent. the key thing about that article is that it is in a major newspaper, and covers the politics in addition to the other stuff, thus providing plausible reasons to the reader why human rights are being violated. this i imagine would be felt as a threat by the bad guys.
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This is a Dutch study. I doubt there is any connection.
 
Dolphin said:
This is a Dutch study. I doubt there is any connection.
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ok. but seems to me there are occasionally global connections. and seemed like a few things [perhaps mostly in the uk] came out on one day last month. could be just coincidence.
 
Researchers from the AMC and Radboudumc examined the effectiveness and safety of this form of treatment. They developed an internet version of behavioral therapy. The advantage of this is that patients do not have to travel for their treatment and that the therapist spends less time giving the therapy.
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So now that the patient doesn't have to get PEM from the travel does that makes CBT an effective treatment?

Isn't this pacing or am I wrong in saying that if simple things like a visit to the clinic need to be eradicated to limit the symptoms of an illness then this is proof that their treatments do not recover people as they cannot meet simple everyday physical tasks that they would be able to when they didn't have a neurological disease.

Also the patients are lucky enough not to have to listen to a babbling idiot CBT therapist as much according to this ....

and that the therapist spends less time giving the therapy.
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....which would be enough relief from unnecessarily caused symptoms for anyone.

Amazing though that this new online therapy takes less time, why would that be? Does the therapist talk twice as fast on skype as they would face to face?

Or perhaps the patient can turn the therapist off easier online or mute them and just nod once in a while.

What a strange message they are trying to convey, "CBT is more effective the less of it you do". I think they are trying to compete with SMILE!
 
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large donner said:
Amazing though that this new online therapy takes less time, why would that be? Does the therapist talk twice as fast on skype as they would face to face?
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It shows that a shorter speaking time is as uneffective as a longer speaking time, but much cheaper. So you need less money to bring people to say "Everything's fine" and stop "complaining" although they feel shitty and cannot earn money.
 
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