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Predictors of response to treatment for chronic fatigue syndrome
Richard P Bentall1, Pauline Powell, Fred J Nye
1Department of Psychology, University of Manchester, Coupland I Building, Oxford Road, Manchester M13 9PL, UK.
Background:
Controlled trials have shown that psychological interventions designed to encourage graded exercise can facilitate recovery from chronic fatigue syndrome.
Aims:
To identify predictors of response to psychological treatment for chronic fatigue syndrome.
Method:
Of 114 patients assigned to equally effective treatment conditions in a randomised, controlled trial, 95 completed follow-up assessments. Relationships between variables measured prior to randomisation and changes in physical functioning and subjective handicap at 1 year were evaluated by multiple regression.
Results:
Poor outcome was predicted by membership of a self-help group, being in receipt of sickness benefit at the start of treatment, and dysphoria as measured by the Hospital Anxiety and Depression scale. Severity of symptoms and duration of illness were not predictors of response.
Conclusions:
Poor outcome in the psychological treatment of chronic fatigue syndrome is predicted by variables that indicate resistance to accepting the therapeutic rationale, poor motivation to treatment adherence or secondary gains from illness.