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An evaluation of multidisciplinary intervention for Chronic Fatigue Syndrome (CFS) with long-term follow-up, & a comparison with untreated controls

  [ 87 votes ]   [ Discuss This Article ]
By Marlin RG, Anchel H, Gibson JC, Goldberg WM, Swinton M • • September 28, 1998

Individuals meeting the Fukuda et al definition for chronic
fatigue syndrome completed a multidisciplinary assessment that
included medical, psychiatric, behavioral, and psychological
evaluations. Patients were then offered a comprehensive
multidisciplinary intervention that included (1) bringing the
patient under optimal medical management; (2) treating any
ongoing affective or anxiety disorder pharmacologically; and
(3) implementing a comprehensive cognitive-behavioral
treatment program. Fifty-one patients proceeded to treatment.

The cognitive-behavioral component was carried out through the
use of a therapist working with the patients in their own
environments. The program was individually tailored to
patients, but included (1) structured physical exercise and
activation; (2) sleep management strategies; (3) careful
activity management; (4) regulation of stimulant intake and
reductions in use of symptomatic medications; (5) cognitive
intervention designed to deal with patients' beliefs
concerning the nature of their disorder; (6) participation of
patients' family; and (7) efforts to establish specific
vocational and avocational goals. Third parties were
encouraged to collaborate cooperatively. Employers were urged
to provide employment opportunities and facilitate a graduated
but time-targeted return to work. Disability carriers were
encouraged to provide interim financial support in the form of
disability benefits, support therapeutic intervention, but
also to establish a clear time-frame to access to benefits. Of
51 treated patients, 31 returned to gainful employment, 14
were functioning at a level equivalent to employment, and 6
remained significantly disabled. Twenty of the original 71
patients were contacted an average of 33 months later.
Patients who had been treated showed good maintenance of
gains. Untreated patients showed improvement in only a
minority of cases.

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