StatPearls: Continuing Education Activity: Chronic fatigue syndrome

[Sly Saint]

Stat Pearls describes itself as
The Largest Library of Medical Education in the World.

https://www.statpearls.com/home/index

Treatment for any comorbid condition should be undertaken to minimize symptom burden.[83][89]

During the CBT sessions, the therapist emphasizes the role of the thought process and its impact on the patient’s actions and feelings and recognizes behaviors that cause them to feel more tired and hence minimize them. Multiple trials and Cochrane reviews have shown the positive benefits of CBT on improving fatigue, mood, and post-exertional malaise in both adolescent and adult patients.[89][90][91][92] Studies have also shown lower school absences when CBT is provided to the adolescent population.[93]

GET involves a supervised, gradual increase in the duration and intensity of physical activity. After the PACE trial, this therapy got much publicity, which showed effectiveness for fatigue and functional impairment with the GET.[80] The trial encouraged the participants to gradually increase the timing of their physical activity to a final goal of 30 minutes, spread over 52 weeks to a final goal of 30 minutes of light exercise five days per week while trying to avoid overexertion. Other studies have also supported its efficacy.[94][95][96]

https://www.statpearls.com/ArticleLibrary/viewarticle/21640

Article Details
Article Author

Conflict of Interest Disclosure
Amit Sapra has no real or apparent conflicts of interest to report" data-original-title="Amit Sapra MD, FAAFP">Amit Sapra
Article Editor:

Conflict of Interest Disclosure
Priyanka Bhandari has no real or apparent conflicts of interest to report" data-original-title="Priyanka Bhandari MD">Priyanka Bhandari
Updated:

6/12/2022 9:58:45 AM
Feedback:

Send Us Your Comments
PubMed Link:

Chronic Fatigue Syndrome

 

[Lou B Lou]

That is outrageous. None of the references appear to be later than 2012 (a quick glance). Edit, seen one from 2017, British Journal of Pharmacology.

There is so much disinformation on 'treatment' for ME or CFS in so many supposedly authoritative publications. It looks like a lifetime's task getting it all updated. In the meantime doctors and students are absorbing outdated damaging misinformation.

 

[J.G]

GET and CBT. How are we still not past this. Unbelievable.

 

[Trish]

I skimmed some of the article. It's muddled and includes some clangers like symptoms being made worse by exertion and low upright posture.
It's clear the writers have just cobbled together bits from various sources and haven't a clue.
@dave30th is this something you can tackle?

 

[J.G]

It's clear the writers have just cobbled together bits from various sources and haven't a clue.

It certainly looks that way. I sent them a polite message explaining, in a few lines, the controversy surrounding the PACE trial and the limitations of CBT for MECFS. I received a response stating they will consider revising the article.

 

[J.G]

I checked back on the article; it's still peppered with BPS lingo and theorem. The passages quoted by @Sly Saint above are unchanged. However I note its new inclusion of two sentences:

Regarding the PACE trial:

"Further analysis of the available data questions the statistical significance of the benefit of CBT and GET."

And concerning CBT and GET in general:

"However, CBT and GET can be adjunct management options, but they are not curative."

Should we wish to address the article's general tenor, I think a more concerted approach is needed. Since that's beyond the scope of my energy limits I hope others on this forum can pick up the slack and raise the issue(s) with StatPearls

 

[CRG]

Statpearls is a private US based company. As far as I can see the business model is selling the Statspearls materials via its corporate access https://www.statpearls.com/home/groupsales/ which is then sold on as courses via the Statspearls website. The institutional base seems to be mostly if not all US based and I think we have to expect that Statpearls' preferred references will be moderated by the interests of its institutional customers so if there's lots of therapy to sell, it's unlikely Statpearls is going to downplay the role of therapy (CBT etc) in treating a condition.

If there's any movement to be had I think it's going to be from referencing publications by the CDC and IOP. The difficulty is going to be that Statpearls probably has little incentive to change what looks like a strongly sciency article which can serve as a tick sheet for 'learning'.

 

[SNT Gatchaman]

It's had an update https://www.ncbi.nlm.nih.gov/books/NBK557676/

Looks muddled and contradictory. They'd do better linking our factsheets.

Eg

Prognosis
CFS has no known cure, and the symptoms can persist for years. The clinical course often fluctuates with remissions and relapses. According to findings from one prospective study, approximately 50% of patients with CFS may return to part-time or full-time employment.[138] Factors associated with poor prognosis include longer duration of illness, comorbid depression, greater fatigue severity, and anxiety.[139] Favorable outcomes are associated with milder fatigue at baseline, a better sense of control over symptoms, and the absence of attributing the disease to a physical cause.[140] Although considerable morbidity is associated with CFS, there is no evidence of increased mortality.

Complications
As with any chronic illness, patients with CFS often experience depression, stress, and anxiety. While CFS is not a psychological condition, it is highly debilitating. Symptom severity can be unpredictable and fluctuate over time. Patients often face ongoing challenges in their education, career, and personal life as they strive to balance obligations and personal goals. Many individuals with CFS describe feeling demoralized or hopeless.

Also

The most crucial factor in patients' successful coping with CFS is establishing a strong relationship with an experienced healthcare professional.

Would be nice…

 

[rvallee]

Also


Would be nice…

An adversarial relationship built on trust. Makes sense if you don't think about it.

Ultimately this is what's insane about this ideology. It's fundamentally adversarial towards us, but everything they do requires trust and relationships, while making such relationships the worst thing ("medicalizing") to do. Cranking up both the A/C and heating at the same time so they perfectly balance each other makes 100x more sense than everything these people have done, combined. This is all completely delusional.