Trial Report Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study, 2024, Van Oudenhove

https://www.sciencedirect.com/science/article/abs/pii/S0022399924003660

Predictors of treatment response trajectories to cognitive behavioral therapy for chronic fatigue syndrome: A cohort study
Lukas Van Oudenhove, Soetkin Debyser, Elfi Vergaelen, Stephan Claes, Maaike Van Den Houte,

Highlights

• There is high variability between CFS patients in the response to CBT.
• Only 32 % of patients showed moderate to strong improvement in fatigue following CBT.
• Non-improvers had higher anxiety, stress, and depressive symptoms before treatment.
• Reductions in anxiety preceded reductions in fatigue during CBT for CFS.
• The depression-fatigue relationship over time was bidirectional.

Abstract

Background
The response to cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) varies greatly between patients, but predictors of treatment success remain to be elucidated. We aimed to identify patient subgroups based on fatigue trajectory during CBT, identify pre-treatment predictors of subgroup membership, and disentangle the direction of predictor – outcome relationships over time.

Methods
297 individuals with CFS were enrolled in a standardized CBT program consisting of 17 sessions, with session timing variable between participants. Self-reported levels of fatigue, depressive, anxiety, and somatic symptoms, perceived stress, and positive affect were collected pre-treatment, and after 3, 10, and 15 sessions. Latent Class Growth Analysis (LCGA) was used to identify subgroups based on fatigue trajectories and baseline predictors of group membership. Cross-lagged structural equation models were used to disentangle predictor-outcome relationships.

Results
LCGA identified four fatigue trajectory subgroups, which were labelled as “no improvement” (23 %), “weak improvement” (45 %), “moderate improvement” (23 %), and “strong improvement” (9 %) classes. Higher pre-treatment levels of depressive, anxiety, and somatic symptoms, stress, and lower levels of positive affect predicted membership of the “no improvement” subgroup. Reductions in anxiety preceded reductions in fatigue, while the depressive symptoms – fatigue relationship was bidirectional.

Conclusions
On a group level, there were statistically significant reductions in fatigue after 15 sessions of CBT, with important individual differences in treatment response. Higher pre-treatment levels of anxious, depressive, and somatic symptoms and perceived stress are predictors of lack of response, with reductions in anxiety and stress preceding improvements in fatigue.

 

How are trials like this even still being allowed?

 

Paywalled, so not possible to know how they defined "CFS".

Also published in the good old Journal of Psychosomatic Research.

 

So CBT isn't even any good for depression and does not work via psychological symptoms?
The people who weren't anxious got less anxious it seems.

 

Ah, along with Psychological Medicine, the house organ of these people.

 

Also, the use of the term "predicted" in association/correlation studies is somewhat deceptive even if common. It can imply "causation" since it suggests that the presence of whatever factor anteceded whatever it is "predicting" will happen. But whether that is or is not the case cannot be determined from associations.

 

Research like this is basically like a LLM that only ever spits out the input. You give it an input, and its output is what you gave it. They pretend to be doing research with some question, and out the end is basically a bunch of the same opinions that support the questions and reframing of the problem.

It's literally the most useless process in the world. There are many processes that are just as useless, they are co-worst, but none are worse.

In literally every single case, if you treated the symptoms, the rest goes away. Explicitly, since the rest only appears to exist because of overlapping questions. But they just stick to the same old nonsense they've had on repeat for decades. As if looking at the problem from the same angle with the same assumptions will somehow give them insight into different conclusions. But they only ever have the one conclusion: the one they started with.

That's because you clowns have been using definitions of depression where fatigue is all it takes. Good grief this is mediocre.

Frankly at this point funding clownish pseudoresearch like this is misconduct and misappropriation of funds. It's no different than using the money to buy themselves expensive cars, and it would actually be less harmful if they did that instead.

 

Fukuda of course.

 

After treatment, 81.1 % of the sample still experienced clinically significant fatigue (score > 76) on the CIS-20 total fatigue score (range: 20-140). For the total group the mean score changed from 112 to 98. The SF-36 physical domain score went from 31.6 before treatment to 35.3 after treatment.



They also found that those that did not improve had more depression, perceived stress, and Somatic symptom severity.