Psychology wiki

Sly Saint · May 2, 2019

psychology wiki

The entry under chronic fatigue syndrome is surprisingly comprehensive, but does not appear to have been updated for a while (ie seems to end at advent of PACE).

Anyone here who could update it/know how to get it updated?
http://psychology.wikia.com/wiki/Chronic_fatigue_syndrome#cite_ref-172

Alvin · Jan 29, 2018

I skimmed it, doesn't seem terrible. That said skimming means i may have missed a bunch, but if anyone has the ability to work on it that would be great.

Sly Saint · Nov 6, 2018

Sly Saint said: ↑

No, I agree that's why I was surprised.
Really its the bit on treatments ie exercise where it references PACE that could do with a bit of an update.
@Carolyn Wilshire
Click to expand...

@Brian Hughes anything you could do on this?

Little Bluestem · Nov 9, 2018

Do you thing the psychology clique will allow any updates to stand?

Sly Saint · Jan 8, 2021

interestingly in the psychology wiki there is this:
"(See section on post-exertion symptom exacerbation."
which is what the new NICE guidelines are using.
Unfortunately, the link doesn't seem to go anywhere and I can't find the section it refers to.

the section on CBT is interesting:

Carruthers and Van de Sande in their Overview of the Canadian Consensus Guidelines[52], note that to supportive counselling should not be mis-termed CBT to avoid patient confusion between the two treatments.
Click to expand...

The Gibson Report [222] states that CBT in general is helpful to many people with other illnesses; and while it is controversial in regards to CFS, it seems to be most effective in those with less severe forms but much less effective in the severely affected. Commenting on the relevance of CBT for CFS, the report states that it has a role to play in treatment but at best is only a partial answer and more research is needed. A systematic review on CBT[227] finds that "CBT was associated with a significant positive effect on fatigue, symptoms, physical functioning and school attendance." The reviewers state that the quality of many recent trails on CBT are lower quality randomized controlled trials or trials that did not involve random allocation. The reviewers also state that one recent, good quality trial of CBT in children and adolscence supports the effectiveness of CBT. The reviewers state that reasons for withdrawals typically remain unreported, and that a degree of publication bias seems to be present in CFS/ME literature as a whole. In one study, the effect of CBT has been demonstrated up to five years after therapy[240].

A large evaluation study in Belgium, however, lead to the conclusion that while on average CBT may cause patients to feel somewhat better, objective measurement shows no reduction in their disability[verification needed][241]. Another recent study found that CBT improved self-reported cognitive impairment but not actual neuropsychological test performance.[242] According to researchers of one study, CBT usually aims at reducing fatigue but can also reduce pain, although higher pain at baseline was associated with a negative treatment outcome.[243] The place of CBT for children, young people and the severely affected needs to be better established, although some open studies suggest that it is helpful, so long as it is adapted for the individual patient
Click to expand...

https://psychology.wikia.org/wiki/Chronic_fatigue_syndrome

it still doesn't appear to have been updated for some time. One to keep an eye on post new NICE guidelines.

eta: the systematic review referred to is this one from 2006
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592057/

Sly Saint · Oct 7, 2021

Sly Saint said: ↑

interestingly in the psychology wiki there is this:
"(See section on post-exertion symptom exacerbation."
which is what the new NICE guidelines are using.
Unfortunately, the link doesn't seem to go anywhere and I can't find the section it refers to.

the section on CBT is interesting:

https://psychology.wikia.org/wiki/Chronic_fatigue_syndrome

it still doesn't appear to have been updated for some time. One to keep an eye on post new NICE guidelines.

eta: the systematic review referred to is this one from 2006
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1592057/
Click to expand...

Have found the section on post-exertion symptom exacerbation

Post-exertion symptom exacerbation
One of the most common and recognizable aspects of CFS is what is called "post-exertional malaise". When people with CFS exert themselves beyond their limits (and their limits may change daily), their symptoms worsen. Exertion includes cognitive effort. The harder the exertion and the longer it lasts, the worse the symptoms will be afterward, and with greater recovery time. Although symptoms may increase immediately and proportionally, usually their full extent is delayed by 24 or more hours, which can make judging appropriate activity difficult.

A cyclical pattern can occur when patients work harder because they "feel better" or are having a "good day", leading them to think they can exert themselves more than usual. However, the excess exertion leads to worse symptoms on the following day. Thus it is difficult for patients to maintain an even level of activity, or to tell if they are improving. In sufferers without a diagnosis of CFS, or a proper understanding of how CFS affects exertion, this can lead to a "downward spiral", where a sufferer will try to work harder to make up for the previous day's lack instead of resting. This exhausts them further, and often can trigger a relapse or worsening of their condition. If the original exertion, which can be physical or mental in nature, was particularly severe, the sufferer may deteriorate to a point where they are unable to care for themselves. Many cases then result in hospitalisation because the condition has deteriorated a great deal.

However, it must be noted that patients may deteriorate due to external stressors, complications, co-morbid illness, or for unknown reasons, and in those cases, patient exertion cannot be blamed for a patient's deterioration. Also, some patients have a progressive course which cannot be explained through activity levels.

When the illness is coupled with unaccommodating family, friends, colleagues, often due to stigma, and social repercussions such as financial needs, housing problems, the struggle to obtain disability benefits or insurance, discrimination and misconception within the care sector, it can put demands on the sufferer exceeding their safe capabilities. Many sufferers describe needing to do things for themselves in the times they feel better simply because there is no-one to delegate to.
Click to expand...

https://psychology.wikia.org/wiki/Chronic_fatigue

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