Research Highlights:
- Expectancy influenced the severity of fatigue and the physical component of the health-related quality of life after multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome.
- Credibility did not significantly influence the outcomes in multidisciplinary rehabilitation treatment or in cognitive behavioural therapy.
- Expectancy was not significantly influenced by baseline factors age, symptoms of depression, duration of illness, or treatment allocation, but was influenced by centre of treatment.
- For future research it is important to study how to increase expectations in order to increase the effectiveness of treatment.
Research abstract:
OBJECTIVE
To improve the effectiveness of treatment in patients with chronic fatigue syndrome it is worthwhile studying factors influencing outcomes. The aims of this study were (1) to assess the association of expectancy and credibility on treatment outcomes, and (2) to identify baseline variables associated with treatment expectancy and credibility.
METHODS
122 patients were included in a randomized controlled trial of whom 60 received cognitive behavioural therapy (CBT) and 62 multidisciplinary rehabilitation treatment (MRT). Expectancy and credibility were measured with the credibility and expectancy questionnaire. Outcomes of treatment, fatigue, and quality of life (QoL), were measured at baseline and post-treatment. Multiple linear regressions were performed to analyse associations.
RESULTS
In explaining fatigue and the physical component of the QoL, the effect of expectancy was significant for MRT, whereas in CBT no such associations were found. The main effect of expectancy on the mental component of QoL was not significant. For credibility, the overall effect on fatigue and the physical component of QoL was not significant. In explaining the mental component of QoL, the interaction between treatment and credibility was significant. However, the effects within each group were not significant.
In the regression model with expectancy as dependent variable, only treatment centre appeared significantly associated. In explaining credibility, treatment centre, treatment allocation and depression contributed significantly.
CONCLUSIONS
For clinical practice it seems important to check the expectations of the patient, since expectations influence the outcome after MRT.
Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS, by D.C.W.M. Vos-Vromans, I.P.J. Huijnen, L.J.M. Rijnders, B. Winkens, J.A. Knottnerus, R.J.E.M. Smeets in Journal of Psychosomatic Research, 16 February 2016
