Predictors of outcome in a multi-component treatment program for chronic fatigue syndrome

Background: Little is known about factors predicting treatment outcome in chronic fatigue syndrome (CFS). Methods: Based on Vercoulen et al.'s (1998) cognitive-behavioral model of perpetuating factors in CFS, the predictive value of the following patient characteristics were examined in a sample of 178 CFS patients who followed a multi-component treatment program: (1) somatic attributions, (2) psychological attributions, (3) sense of control over symptoms, (4) physical activity, (5) functional impairment, (6) somatic focus, and (7) severity of depression. Results: Only pre-treatment severity of depression was associated with negative treatment outcome defined in terms of post-treatment fatigue and improvement in fatigue. Limitations: The study was conducted at a tertiary care centre and did not include a control group or a long-term follow-up. Conclusions: Level of depression may be the most important factor of the cognitive-behavioral model predicting post-treatment fatigue in CFS. Hence, findings suggest that treatment of CFS should include a focus on severity of depression. (C) 2010 Elsevier B.V. All rights reserved.