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Efficacy of cognitive–behavioural therapy by general practitioners for unexplained fatigue among employees: Randomised controlled trial

  • Marcus J. H. Huibers (a1), Anna J. H. M. Beurskens (a2), Constant P. Van Schayck (a3), Ellen Bazelmans (a4), Job F. M. Metsemakers (a3), J André Knottnerus (a3) and Gijs Bleijenberg (a5)...
Abstract
Background

Fatigue is a common complaint that may lead to long-term sick leave and work disability.

Aims

To assess the efficacy of cognitive–behavioural therapy by general practitioners for unexplained, persistent fatigue among employees.

Method

A randomised controlled trial, using a pre-randomisation design in primary care, investigated 151 employees on sick leave with fatigue. Participants in the experimental group were offered five to seven 30 min sessions of cognitive–behavioural therapy by a general practitioner; those in the control group were offered no treatment. Main outcome measures (fatigue severity self-reported absenteeism, registered absenteeism and clinical recovery) were assessed at 4 months, 8 months and 12 months.

Results

At baseline, 44% of the patients already met research criteria for chronic fatigue syndrome. There was no significant difference between the experimental group and the control group on primary or secondary outcomes at any point.

Conclusions

Cognitive–behavioural therapy by general practitioners for unexplained, persistent fatigue did not prove to be an effective intervention. Since these doctors were unable to deliver this therapy effectively under ideal circumstances, it is unlikely that doctors in routine practice would be more successful in doing so.

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Copyright
Corresponding author
Correspondence: M.J. H. Huibers, Department of Medical, Clinical and Experimental Psychology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Tel: +3143 388 1487; fax: +31 43 388 4155; e-mail: m.huibers@dmkep.unimaas.nl
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Declaration of interest

None. Funding detailed in Acknowledgements.

Footnotes
References
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Amelsvoort, L. G. P. M. van, Kant, IJ., Beurskens, A. J. H. M., et al (2002) Fatigue as a predictor of work disability. Occupational and Environmental Medicine, 59, 712713.
Beurskens, A. J. H. M., Bültmann, U., Kant, IJ., et al (2000) Fatigue among working people: validity of a questionnaire measure. Occupational and Environmental Medicine, 57, 353357.
Bültmann, U., Kant, IJ., Kasl, S.V., et al (2002) Fatigue and psychological distress in the working population: psychometrics, prevalence and correlates. Journal of Psychosomatic Research, 52, 445452.
Derogatis, L. R., Lipman, R. S. & Covi, L. (1973) SCL-90: an outpatient psychiatric rating scale – preliminary report. Psychopharmacological Bulletin, 9, 1328.
Feinstein, A. R. (1987) Clinimetrics. New Haven, CT: Yale University Press.
Fukuda, K., Straus, S. E., Hickie, I., et al (1994) The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine, 121, 953959.
Huibers, M. J. H., Beurskens, A. J. H. M., Prins, J. B., et al (2003a) Fatigue, burnout and chronic fatigue syndrome among employees on sick leave: do attributions make the difference? Occupational and Environmental Medicine, 60 (suppl. 1), i26i31.
Huibers, M. J. H., Beurskens, A. J. H. M., Bleijenberg, G., et al (2003b) The effectiveness of psychosocial interventions delivered by general practitioners. Cochrane Library, issue 2. Oxford: Update Software.
Janssen, N., Kant, IJ., Swaen, G. M. H., et al (2003) Fatigue as a predictor of sickness absence: results from the Maastricht cohort study on fatigue at work. Occupational and Environmental Medicine, 60 (suppl. 1), i71i76.
Kant, IJ., Bültmann, U., Schroer, C. A. P., et al (2003) An epidemiological approach to study fatigue in the working population: the Maastricht Cohort Study. Occupational and Environmental Medicine, 60 (suppl. 1), i32i39.
King, M., Davidson, O., Taylor, F., et al (2002) Effectiveness of teaching general practitioners skills in brief cognitive behaviour therapy to treat patients with depression: randomised controlled trial. BMJ, 324, 947953.
Knottnerus, J. A. (1997) Health care research in extramural settings [in Dutch]. In Ethiek en recht in de gezondheidszorg [Ethics and law in health care] (eds Ten Have, H. A. M. J., Blijham, G. & Engberts, D. P.), pp. 151198. Deventer: Kluwer.
Lewis, G. & Wessely, S. (1992) The epidemiology of fatigue: more questions than answers. Journal of Epidemiology and Community Health, 46, 9297.
Mayou, R. & Farmer, A. (2002) ABC of psychological medicine: functional somatic symptoms and syndromes. BMJ, 325, 265268.
Mynors-Wallis, L. M., Gath, D. H., Lloyd Thomas, A. R., et al (1995) Randomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression in primary care. BMJ, 310, 441445.
Mynors-Wallis, L. M., Gath, D. H., Day, A., et al (2000) Randomised controlled trial of problem solving treatment, antidepressant medication, and combined treatment for major depression in primary care. BMJ, 320, 2630.
Pawlikowska, T., Chalder, T., Hirsch, S., et al (1994) Population based study of fatigue and psychological distress. BMJ, 308, 763766.
Prins, J. B., Bleijenberg, G., Bazelmans, E., et al (2001) Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial. Lancet, 357, 841847.
Raine, R., Haines, A., Sensky, T., et al (2002) Systematic review of mental health interventions for patients with common somatic symptoms: can research evidence from secondary care be extrapolated to primary care? BMJ, 325, 10821093.
Ridsdale, L., Godfrey, E., Chalder, T., et al (2001) Chronic fatigue in general practice: is counselling as good as cognitive behaviour therapy? AUK randomised trial. British Journal of General Practice, 51, 1924.
Scott, J. & Sensky, T. (2003) Methodological aspects of randomized controlled trials of psychotherapy in primary care. Psychological Medicine, 33, 191196.
Sharpe, M. & Wilks, D. (2002) ABC of psychological medicine: fatigue. BMJ, 325, 480483.
Van der Werf, S. P., Prins, J. B., Vercoulen, J. H., et al (2000) Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. Journal of Psychosomatic Research, 49, 373379.
Vercoulen, J. H. M. M., Swanink, C. M., Fennis, J. F., et al (1996) Prognosis in chronic fatigue syndrome: a prospective study on the natural course. Journal of Neurology, Neurosurgery and Psychiatry, 60, 489494.
Vercoulen, J. H. M. M., Alberts, M. & Bleijenberg, G. (1999) The Checklist Individual Strength (CIS) [in Dutch]. Gedragstherapie, 32, 3136.
Ware, J.E. Sherbourne, C. D. (1992) The MOS36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473483.
Wessely, S., Nimnuan, C. & Sharpe, M. (1999) Functional somatic syndromes: one or many? Lancet, 354, 936939.
Whitehead, L. & Campion, P. (2002) Can general practitioners manage chronic fatigue syndrome? A controlled trial. Journal of Chronic Fatigue Syndrome, 10, 5564.
Whiting, P., Bagnall, A. M., Sowden, A. J., et al (2001) Interventions for the treatment and management of chronic fatigue syndrome: a systematic review. JAMA, 286, 13601368.
Zelen, M. (1990) Randomised consent designs for clinical trials: an update. Statistics in Medicine, 9, 645656.
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Efficacy of cognitive–behavioural therapy by general practitioners for unexplained fatigue among employees: Randomised controlled trial

  • Marcus J. H. Huibers (a1), Anna J. H. M. Beurskens (a2), Constant P. Van Schayck (a3), Ellen Bazelmans (a4), Job F. M. Metsemakers (a3), J André Knottnerus (a3) and Gijs Bleijenberg (a5)...
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