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Predictors of response to treatment for chronic fatigue syndrome

University of Manchester

PAULINE POWELL, PhD and FRED J. NYE, FRCP

Royal Liverpool Broadgreen Trust

RICHARD H. T. EDWARDS, FRCP (retired)

formerly University of Liverpool, UK

Correspondence: Professor Richard Bentall, Department of Psychology, University of Manchester, Coupland I Building, Oxford Road, Manchester M13 9PL, UK

Declaration of interest None.

Financial support from the Linbury Trust.

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.

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