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Efficacy of web-based cognitive-behavioural therapy for chronic fatigue syndrome: randomised controlled trial
A Janse1, M Worm-Smeitink1, G Bleijenberg2
1Academic Medical Center (AMC),University of Amsterdam,Department of Medical Psychology,Amsterdam Public Health Research Institute,Amsterdam,the Netherlands.
Background:
Face-to-face cognitive-behavioural therapy (CBT) leads to a reduction of fatigue in chronic fatigue syndrome (CFS). Aims To test the efficacy of internet-based CBT (iCBT) for adults with CFS.
Method:
A total of 240 patients with CFS were randomised to either iCBT with protocol-driven therapist feedback or with therapist feedback on demand, or a waiting list. Primary outcome was fatigue severity assessed with the Checklist Individual Strength (Netherlands Trial Register: NTR4013).
Results:
Compared with a waiting list, intention-to-treat (ITT) analysis showed a significant reduction of fatigue for both iCBT conditions (protocol-driven feedback: B = -8.3, 97.5% CI -12.7 to -3.9, P < 0.0001; feedback on demand: B = -7.2, 97.5% CI -11.3 to -3.1, P < 0.0001). No significant differences were found between both iCBT conditions on all outcome measures (P = 0.3-0.9). An exploratory analysis revealed that feedback-on-demand iCBT required less therapist time (mean 4 h 37 min) than iCBT with protocol-driven feedback (mean 6 h 9 min, P < 0.001) and also less than face-to-face CBT as reported in the literature.
Conclusions:
Both iCBT conditions are efficacious and time efficient. Declaration of interest None.
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