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

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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