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Simon Wessely - One of the best experts on this subject based on the ideXlab platform.
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cognitive behavioural therapy for Chronic Fatigue and Chronic Fatigue Syndrome outcomes from a specialist clinic in the uk
Journal of the Royal Society of Medicine, 2020Co-Authors: James Adamson, Simon Wessely, Trudie Chalder, Sheila Ali, Alastair M SanthouseAbstract:ObjectivesCognitive behavioural therapy is commonly used to treat Chronic Fatigue Syndrome and has been shown to be effective for reducing Fatigue and improving physical functioning. Most of the ev...
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mortality of people with Chronic Fatigue Syndrome a retrospective cohort study in england and wales from the south london and maudsley nhs foundation trust biomedical research centre slam brc clinical record interactive search cris register
The Lancet, 2016Co-Authors: Emmert Roberts, Trudie Chalder, Simon Wessely, Chinkuo Chang, Matthew HotopfAbstract:Summary Background Mortality associated with Chronic Fatigue Syndrome is uncertain. We investigated mortality in individuals diagnosed with Chronic Fatigue Syndrome in secondary and tertiary care using data from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Clinical Record Interactive Search (CRIS) register. Methods We calculated standardised mortality ratios (SMRs) for all-cause, suicide-specific, and cancer-specific mortality for a 7-year observation period using the number of deaths observed in SLaM records compared with age-specific and sex-specific mortality statistics for England and Wales. Study participants were included if they had had contact with the Chronic Fatigue service (referral, discharge, or case note entry) and received a diagnosis of Chronic Fatigue Syndrome. Findings We identified 2147 cases of Chronic Fatigue Syndrome from CRIS and 17 deaths from Jan 1, 2007, to Dec 31, 2013. 1533 patients were women of whom 11 died, and 614 were men of whom six died. There was no significant difference in age-standardised and sex-standardised mortality ratios (SMRs) for all-cause mortality (SMR 1·14, 95% CI 0·65–1·85; p=0·67) or cancer-specific mortality (1·39, 0·60–2·73; p=0·45) in patients with Chronic Fatigue Syndrome when compared with the general population in England and Wales. This remained the case when deaths from suicide were removed from the analysis. There was a significant increase in suicide-specific mortality (SMR 6·85, 95% CI 2·22–15·98; p=0·002). Interpretation We did not note increased all-cause mortality in people with Chronic Fatigue Syndrome, but our findings show a substantial increase in mortality from suicide. This highlights the need for clinicians to be aware of the increased risk of completed suicide and to assess suicidality adequately in patients with Chronic Fatigue Syndrome. Funding National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
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comment on detection of an infectious retrovirus xmrv in blood cells of patients with Chronic Fatigue Syndrome
Science, 2010Co-Authors: Andrew R Lloyd, Michael Sharpe, Simon Wessely, Peter D White, Dedra BuchwaldAbstract:Chronic Fatigue Syndrome (CFS) is a debilitating disease of unknown etiology that is estimated to affect 17 million people worldwide. Studying peripheral blood mononuclear cells (PBMCs) from CFS patients, we identified DNA from a human gammaretrovirus, xenotropic murine leukemia virus-related virus (XMRV), in 68 of 101 patients (67%) compared to 8 of 218 (3.7%) healthy controls. Cell culture experiments revealed that patient-derived XMRV is infectious and that both cellassociated and cell-free transmission of the virus are possible. Secondary viral infections were established in uninfected primary lymphocytes and indicator cell lines following exposure to activated PBMCs, B cells, T cells, or plasma derived from CFS patients. These findings raise the possibility that XMRV may be a contributing factor in the pathogenesis of CFS. Chronic Fatigue Syndrome (CFS) is a disorder of unknown etiology that affects multiple organ systems in the body. Patients with CFS display abnormalties in immune system
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etiology of Chronic Fatigue Syndrome testing popular hypotheses using a national birth cohort study
Psychosomatic Medicine, 2008Co-Authors: Samuel B Harvey, Simon Wessely, Michael Wadsworth, Matthew HotopfAbstract:Objective:To review the etiology of Chronic Fatigue Syndrome (CFS) and test hypotheses relating to immune system dysfunction, physical deconditioning, exercise avoidance, and childhood illness experiences, using a large prospective birth cohort.Methods:A total of 4779 participants from the Medical R
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incidence prognosis and risk factors for Fatigue and Chronic Fatigue Syndrome in adolescents a prospective community study
Pediatrics, 2007Co-Authors: Katharine A Rimes, Matthew Hotopf, Simon Wessely, Robert Goodman, Howard Meltzer, Trudie ChalderAbstract:OBJECTIVE.The objective of this study was to describe the incidence, prevalence, risk factors, and prognosis of Fatigue, Chronic Fatigue, and Chronic Fatigue Syndrome in 11- to 15-year-olds. METHODS.A random general population sample (n 842) of British adolescents and their parents were assessed at baseline and 4 to 6 months later. The main outcomes were Fatigue, Chronic Fatigue, and Chronic Fatigue Syndrome, operationally defined. RESULTS.The incidence over 4 to 6 months was 30.3% for Fatigue, 1.1% for Chronic Fatigue, and 0.5% for Chronic Fatigue Syndrome. The point prevalence was 34.1% and 38.1% for Fatigue, 0.4% and 1.1% for Chronic Fatigue, and 0.1% and 0.5% for Chronic Fatigue Syndrome at time 1 and time 2, respectively. Of participants who were Fatigued at time 1, 53% remained Fatigued at time 2. The 3 cases of Chronic Fatigue and 1 case of Chronic Fatigue Syndrome at time 1 had recovered by time 2. Higher risk for development of Chronic Fatigue at time 2 was associated with time 1 anxiety or depression, conduct disorder, and maternal distress; in multivariate analysis, baseline anxiety or depression remained a significant predictor of Chronic Fatigue. Increased risk for development of Fatigue at time 2 was associated with time 1 anxiety or depression, conduct disorder, and older age; in multivariate analyses, these factors and female gender all were significant predictors of Fatigue. CONCLUSIONS.The incidence rates for Chronic Fatigue and Chronic Fatigue Syndrome in this adolescent sample were relatively high, but the prognosis for these conditions was good. This prospective study provides evidence for an association between emotional/behavioral problems and subsequent onset of Fatigue/Chronic Fatigue.
Gijs Bleijenberg - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of internet based cognitive behavioural treatment for adolescents with Chronic Fatigue Syndrome fitnet a randomised controlled trial
The Lancet, 2012Co-Authors: Sanne L Nijhof, Gijs Bleijenberg, Cuno S P M Uiterwaal, Jan L L Kimpen, Elise M Van De PutteAbstract:Summary Background Chronic Fatigue Syndrome is characterised by persistent Fatigue and severe disability. Cognitive behavioural therapy seems to be a promising treatment, but its availability is restricted. We developed Fatigue In Teenagers on the interNET (FITNET), the first dedicated internet-based therapeutic program for adolescents with this disorder, and compared its effectiveness with that of usual care. Methods Adolescents aged 12–18 years with Chronic Fatigue Syndrome were assigned to FITNET or usual care in a 1:1 ratio at one tertiary treatment centre in the Netherlands by use of a computer-generated blocked randomisation allocation schedule. The study was open label. Primary outcomes were school attendance, Fatigue severity, and physical functioning, and were assessed at 6 months with computerised questionnaires. Analysis was by intention to treat. Thereafter, all patients were offered FITNET if needed. This trial is registered, number ISRCTN59878666. Findings 68 of 135 adolescents were assigned to FITNET and 67 to usual care, and 67 and 64, respectively, were analysed. FITNET was significantly more effective than was usual care for all dichotomised primary outcomes at 6 months—full school attendance (50 [75%] vs 10 [16%], relative risk 4·8, 95% CI 2·7–8·9; p vs 17 [27%], 3·2, 2·1–4·9; p vs 13 [20%], 3·8, 2·3–6·3; p Interpretation FITNET offers a readily accessible and highly effective treatment for adolescents with Chronic Fatigue Syndrome. The results of this study justify implementation on a broader scale. Funding Netherlands Organisation for Health Research and Development.
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prevalence of xenotropic murine leukaemia virus related virus in patients with Chronic Fatigue Syndrome in the netherlands retrospective analysis of samples from an established cohort
BMJ, 2010Co-Authors: Frank J M Van Kuppeveld, Gijs Bleijenberg, C M A Swanink, Arjan S De Jong, Kjerstin Lanke, Gerald W Verhaegh, Willem J G Melchers, Mihai G Netea, Jochem M D Galama, Jos W M Van Der MeerAbstract:Objective The presence of the retrovirus xenotropic murine leukaemia virus-related virus (XMRV) has been reported in peripheral blood mononuclear cells of patients with Chronic Fatigue Syndrome. Considering the potentially great medical and social relevance of such a discovery, we investigated whether this finding could be confirmed in an independent European cohort of patients with Chronic Fatigue Syndrome. Design Analysis of a well defined cohort of patients and matched neighbourhood controls by polymerase chain reaction.
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guided self instructions for people with Chronic Fatigue Syndrome randomised controlled trial
British Journal of Psychiatry, 2008Co-Authors: Hans Knoop, Jos W M Van Der Meer, Gijs BleijenbergAbstract:A minimal intervention, based on cognitive-behavioural therapy for Chronic Fatigue Syndrome and consisting of self-instructions combined with email contact, was tested in a randomised controlled trial (ISRCTN27293439). A total of 171 patients participated in the trial: 85 were allocated to the intervention condition and 86 to the waiting-list condition. All patients met the Centers for Disease Control and Prevention criteria for Chronic Fatigue Syndrome. An intention-to-treat analysis showed a significant decrease in Fatigue and disability after self-instruction. The level of disability was negatively correlated with treatment outcome. Guided self-instructions are an effective treatment for patients with relatively less severe Chronic Fatigue Syndrome.
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is a full recovery possible after cognitive behavioural therapy for Chronic Fatigue Syndrome
Psychotherapy and Psychosomatics, 2007Co-Authors: Hans Knoop, Gijs Bleijenberg, J.w.m. Van Der Meer, Marieke F M Gielissen, Peter D WhiteAbstract:Background: Cognitive behavioural therapy (CBT) for Chronic Fatigue Syndrome (CFS) leads to a decrease in symptoms and disabilities. There is controversy about the nature of the cha
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Chronic Fatigue Syndrome
The Lancet, 2006Co-Authors: Judith B Prins, J.w.m. Van Der Meer, Gijs BleijenbergAbstract:Summary During the past two decades, there has been heated debate about Chronic Fatigue Syndrome (CFS) among researchers, practitioners, and patients. Few illnesses have been discussed so extensively. The existence of the disorder has been questioned, its underlying pathophysiology debated, and an effective treatment opposed; patients' organisations have participated in scientific discussions. In this review, we look back on several controversies over CFS with respect to its definition, diagnosis, pathophysiology, and treatment. We review issues of epidemiology and clinical manifestations, focusing on the scientific status of CFS. Modern neuroscience and genetics research offer interesting findings for new hypotheses on the aetiology and pathogenesis of the illness. We also discuss promising future issues, such as psychopathophysiology and mechanisms of improvement, and suggest multidisciplinary prospective studies of CFS and Fatigue in the general population. These studies should pay particular attention to similarities to and differences from functional somatic Syndromes and other fatiguing conditions.
Timothy J Henrich - One of the best experts on this subject based on the ideXlab platform.
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xenotropic murine leukemia virus related virus prevalence in patients with Chronic Fatigue Syndrome or Chronic immunomodulatory conditions
The Journal of Infectious Diseases, 2010Co-Authors: Jonathan Z Li, Timothy J Henrich, Camille N. Kotton, Donna FelsensteinAbstract:We investigated the prevalence of xenotropic murine leukemia virus-related virus (XMRV) among 293 participants seen at academic hospitals in Boston, Massachusetts. Participants were recruited from the following 5 groups of patients: Chronic Fatigue Syndrome (n = 32), human immunodeficiency virus infection (n = 43), rheumatoid arthritis (n = 97), hematopoietic stem-cell or solid organ transplant (n = 26), or a general cohort of patients presenting for medical care (n = 95). XMRV DNA was not detected in any participant samples. We found no association between XMRV and patients with Chronic Fatigue Syndrome or Chronic immunomodulatory conditions.
Camille N. Kotton - One of the best experts on this subject based on the ideXlab platform.
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xenotropic murine leukemia virus related virus prevalence in patients with Chronic Fatigue Syndrome or Chronic immunomodulatory conditions
The Journal of Infectious Diseases, 2010Co-Authors: Jonathan Z Li, Timothy J Henrich, Camille N. Kotton, Donna FelsensteinAbstract:We investigated the prevalence of xenotropic murine leukemia virus-related virus (XMRV) among 293 participants seen at academic hospitals in Boston, Massachusetts. Participants were recruited from the following 5 groups of patients: Chronic Fatigue Syndrome (n = 32), human immunodeficiency virus infection (n = 43), rheumatoid arthritis (n = 97), hematopoietic stem-cell or solid organ transplant (n = 26), or a general cohort of patients presenting for medical care (n = 95). XMRV DNA was not detected in any participant samples. We found no association between XMRV and patients with Chronic Fatigue Syndrome or Chronic immunomodulatory conditions.
Trudie Chalder - One of the best experts on this subject based on the ideXlab platform.
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cognitive behavioural therapy for Chronic Fatigue and Chronic Fatigue Syndrome outcomes from a specialist clinic in the uk
Journal of the Royal Society of Medicine, 2020Co-Authors: James Adamson, Simon Wessely, Trudie Chalder, Sheila Ali, Alastair M SanthouseAbstract:ObjectivesCognitive behavioural therapy is commonly used to treat Chronic Fatigue Syndrome and has been shown to be effective for reducing Fatigue and improving physical functioning. Most of the ev...
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mortality of people with Chronic Fatigue Syndrome a retrospective cohort study in england and wales from the south london and maudsley nhs foundation trust biomedical research centre slam brc clinical record interactive search cris register
The Lancet, 2016Co-Authors: Emmert Roberts, Trudie Chalder, Simon Wessely, Chinkuo Chang, Matthew HotopfAbstract:Summary Background Mortality associated with Chronic Fatigue Syndrome is uncertain. We investigated mortality in individuals diagnosed with Chronic Fatigue Syndrome in secondary and tertiary care using data from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Clinical Record Interactive Search (CRIS) register. Methods We calculated standardised mortality ratios (SMRs) for all-cause, suicide-specific, and cancer-specific mortality for a 7-year observation period using the number of deaths observed in SLaM records compared with age-specific and sex-specific mortality statistics for England and Wales. Study participants were included if they had had contact with the Chronic Fatigue service (referral, discharge, or case note entry) and received a diagnosis of Chronic Fatigue Syndrome. Findings We identified 2147 cases of Chronic Fatigue Syndrome from CRIS and 17 deaths from Jan 1, 2007, to Dec 31, 2013. 1533 patients were women of whom 11 died, and 614 were men of whom six died. There was no significant difference in age-standardised and sex-standardised mortality ratios (SMRs) for all-cause mortality (SMR 1·14, 95% CI 0·65–1·85; p=0·67) or cancer-specific mortality (1·39, 0·60–2·73; p=0·45) in patients with Chronic Fatigue Syndrome when compared with the general population in England and Wales. This remained the case when deaths from suicide were removed from the analysis. There was a significant increase in suicide-specific mortality (SMR 6·85, 95% CI 2·22–15·98; p=0·002). Interpretation We did not note increased all-cause mortality in people with Chronic Fatigue Syndrome, but our findings show a substantial increase in mortality from suicide. This highlights the need for clinicians to be aware of the increased risk of completed suicide and to assess suicidality adequately in patients with Chronic Fatigue Syndrome. Funding National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
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rehabilitative therapies for Chronic Fatigue Syndrome a secondary mediation analysis of the pace trial
The Lancet Psychiatry, 2015Co-Authors: Trudie Chalder, Michael Sharpe, Peter D White, Kimberley Goldsmith, Andrew PicklesAbstract:Summary Background Cognitive behaviour therapy (CBT) added to specialist medical care (SMC), or graded exercise therapy (GET) added to SMC, are more effective in reducing Fatigue and improving physical function than both adaptive pacing therapy (APT) plus SMC and SMC alone for Chronic Fatigue Syndrome. We investigate putative treatment mechanisms. Methods We did a planned secondary mediation analysis of the PACE trial comparing SMC alone or SMC plus APT with SMC plus CBT and SMC plus GET for patients with Chronic Fatigue Syndrome. 641 participants were recruited from six specialist Chronic Fatigue Syndrome clinics in the UK National Health Service between March 18, 2005, and Nov 28, 2008. We assessed mediation using the product of coefficients method with the 12 week measure of the mediators and the 52 week measure of the outcomes. The primary outcomes were Fatigue measured by the Chalder Fatigue scale and physical function measured by the physical function subscale of the SF-36. We included confounder covariates and used treatment by mediator interaction terms to examine differences in mediator–outcome relations by treatment group. Findings The largest mediated effect for both CBT and GET and both primary outcomes was through fear avoidance beliefs with an effect of larger magnitude for GET (standardised effects ×10, CBT vs APT, Fatigue −1·22, 95% CI −0·52 to −1·97, physical function 1·54, 0·86 to 2·31; GET vs APT, Fatigue −1·86, −0·80 to −2·89, physical function 2·35, 1·35 to 3·39). Increase in exercise tolerance (6 min walk distance) was a potent mediator of the effect of GET ( vs APT, Fatigue −1·37, 95% CI −0·76 to −2·21, physical function 1·90, 1·10 to 2·91), but not CBT. Interpretation Our main finding was that fear avoidance beliefs were the strongest mediator for both CBT and GET. Changes in both beliefs and behaviour mediated the effects of both CBT and GET, but more so for GET. The results support a treatment model in which both beliefs and behaviour play a part in perpetuating Fatigue and disability in Chronic Fatigue Syndrome. Funding UK Medical Research Council, Department of Health for England, Scottish Chief Scientist Office, Department for Work and Pensions, National Institute for Health Research (NIHR), NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust, and Institute of Psychiatry, Psychology, and Neuroscience, King's College London.
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incidence prognosis and risk factors for Fatigue and Chronic Fatigue Syndrome in adolescents a prospective community study
Pediatrics, 2007Co-Authors: Katharine A Rimes, Matthew Hotopf, Simon Wessely, Robert Goodman, Howard Meltzer, Trudie ChalderAbstract:OBJECTIVE.The objective of this study was to describe the incidence, prevalence, risk factors, and prognosis of Fatigue, Chronic Fatigue, and Chronic Fatigue Syndrome in 11- to 15-year-olds. METHODS.A random general population sample (n 842) of British adolescents and their parents were assessed at baseline and 4 to 6 months later. The main outcomes were Fatigue, Chronic Fatigue, and Chronic Fatigue Syndrome, operationally defined. RESULTS.The incidence over 4 to 6 months was 30.3% for Fatigue, 1.1% for Chronic Fatigue, and 0.5% for Chronic Fatigue Syndrome. The point prevalence was 34.1% and 38.1% for Fatigue, 0.4% and 1.1% for Chronic Fatigue, and 0.1% and 0.5% for Chronic Fatigue Syndrome at time 1 and time 2, respectively. Of participants who were Fatigued at time 1, 53% remained Fatigued at time 2. The 3 cases of Chronic Fatigue and 1 case of Chronic Fatigue Syndrome at time 1 had recovered by time 2. Higher risk for development of Chronic Fatigue at time 2 was associated with time 1 anxiety or depression, conduct disorder, and maternal distress; in multivariate analysis, baseline anxiety or depression remained a significant predictor of Chronic Fatigue. Increased risk for development of Fatigue at time 2 was associated with time 1 anxiety or depression, conduct disorder, and older age; in multivariate analyses, these factors and female gender all were significant predictors of Fatigue. CONCLUSIONS.The incidence rates for Chronic Fatigue and Chronic Fatigue Syndrome in this adolescent sample were relatively high, but the prognosis for these conditions was good. This prospective study provides evidence for an association between emotional/behavioral problems and subsequent onset of Fatigue/Chronic Fatigue.
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salivary cortisol response to awakening in Chronic Fatigue Syndrome
British Journal of Psychiatry, 2004Co-Authors: Amanda Roberts, Andrew Papadopoulos, Simon Wessely, Trudie Chalder, Anthony J. CleareAbstract:Background: There is accumulating evidence of hypothalamic-pituitary-adrenal (HPA) axis disturbances in Chronic Fatigue Syndrome (CFS). The salivary cortisol response to awakening hasbeen described recentlyas a non-invasive test of the capacityof the HP Aaxis to respond to stress. The results of this test correlate closely with those of more invasive dynamic tests reported in the literature; furthermore, i tcan be undertaken in a naturalistic setting. Aims: To assess the HPA axis using the salivary cortisol response to awakening in CFS. Method: We measured salivary cortisol upon awakening and 10, 20, 30 and 60 min afterwards in 56 patients with CFS and 35 healthy volunteers. Results: Patients had a lower cortisol response to awakening, measured by the area under the curve. Conclusions: This naturalistic test of the HPA axis response to stress showed impaired HPA axis function in CFS.