Review Is the effect of CBT for CFS moderated by the presence of comorbid depressive symptoms? A meta-analysis of three treatment delivery formats, 2024,Kuut

[Dolphin]

Free fulltext:
https://www.sciencedirect.com/science/article/pii/S0022399924002629

Journal of Psychosomatic Research
Available online 22 June 2024, 111850
In Press, Journal Pre-proof

Short communication
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
T.A. Kuut, L.M. Buffart, A.M.J. Braamse, F. Müller, H. Knoop
https://doi.org/10.1016/j.jpsychores.2024.111850


open access

Highlights

• Outcomes of CBT for ME/CFS are moderated by depression in different formats.
  
  
• ME/CFS patients with depressive symptoms benefit less from internet-based CBT.
  
  
• Currently, face-to-face CBT is advised for ME/CFS patients with depressive symptoms.
  
  
• Internet-based CBT should be adapted for ME/CFS patients with depressive symptoms.

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 format.

Methods
Data from six randomized 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.

Keywords
ME/CFS
Depression
Therapy format

https://twitter.com/user/status/1806372899428941991

 

[rvallee]

For sure this all has to be one of the most successful grifts in history. The same idea just keeps going on decade after decade, forever expanding, never delivering a damn thing.

They don't even seem to understand the words they're using. It's all so random and jumbled.

 

[alktipping]

patients who are really suffering with depression would not be engaging online with these apps. which ironically would be better for their long term health .

 

[bobbler]

Free fulltext:
https://www.sciencedirect.com/science/article/pii/S0022399924002629

Journal of Psychosomatic Research
Available online 22 June 2024, 111850
In Press, Journal Pre-proof

Short communication
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
T.A. Kuut, L.M. Buffart, A.M.J. Braamse, F. Müller, H. Knoop
https://doi.org/10.1016/j.jpsychores.2024.111850


open access

Highlights

• •
  Outcomes of CBT for ME/CFS are moderated by depression in different formats.
  
  
• •
  ME/CFS patients with depressive symptoms benefit less from internet-based CBT.
  
  
• •
  Currently, face-to-face CBT is advised for ME/CFS patients with depressive symptoms.
  
  
• •
  Internet-based CBT should be adapted for ME/CFS patients with depressive symptoms.

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 format.

Methods
Data from six randomized 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.

Keywords
ME/CFS
Depression
Therapy format

Shocking really

the gravy train just carries on pretending it never happened that it was confirmed CBT doesn’t treat ME/CFS and isn’t effective for it in any mode

I read this in the hope it was a sane person talking about those needing depression support that wasn’t ‘reactive’ or ‘situational’ but who also had ME/CFs

it’s disgusting frankly the parsing and con artistry going on in the ‘profession’ where they think they can take something ineffective and discuss how internet is even less effective to infer any of them are of any use to the reader who wouldn’t assume the country would allow funding to be toileted on: these are both useless let’s compare which one is the most useless

do we see studies talking about which brand of soft drink is least effective at treating arthritis

or whether offering online or in person guitar lessons is the least effective at treating diabetes?

 

[bobbler]

For sure this all has to be one of the most successful grifts in history. The same idea just keeps going on decade after decade, forever expanding, never delivering a damn thing.

They don't even seem to understand the words they're using. It's all so random and jumbled.

“You won’t take away my toy”

why are there not rules in advertising and misinformation for the one area that it is the most important out of any?

what is the sickest thing is the fact these people think having a certain tone means their intention is to help even tho as these things offer no help and take money (and energy) from someone/ somewhere at best - and stand in the way of real researchers who actually want to develop something that might help based on proper insight

are then literally attacking people psychologically and situationally when lies are told inferring if they tried harder in that con they wouldn’t be ill. At which point they play dumb and pretend they can’t see it - callous indifference, cos they know

how screwed up and in denial are some people?

 

[Trish]

The BDI-PC is a 7 item questionnaire with each item rated on a 4 point scale (0–3). It is scored by summing ratings for each item (range 0–21). Items are symptoms of sadness, pessimism, past failure, loss of pleasure, self dislike, self criticalness, and suicidal thoughts and wishes.

 

[perchance dreamer]

Years ago, a biofeedback and neurofeedback therapist taught me a really simple mind/body technique to lessen the perception of pain. She didn't use psychobabble or insulting terms such as catastrophising my pain. She just said this technique could lessen the pain by making me feel more distant from it. It often works, so I still use it sometimes, but find it more helpful for acute rather than chronic pain.

Anyway, later when CBT became popular, I didn't understand why a mind/body technique was couched in such condescending, off-putting language.