Cognitive-behavioural therapy combined with music therapy for chronic fatigue following Epstein-Barr virus infection in adolescents: a feasibility study.
Epstein-Barr virus infection
adolescents
chronic fatigue
chronic fatigue syndrome
cognitive–behavioural therapy
music therapy
Journal
BMJ paediatrics open
ISSN: 2399-9772
Titre abrégé: BMJ Paediatr Open
Pays: England
ID NLM: 101715309
Informations de publication
Date de publication:
2020
2020
Historique:
received:
03
12
2019
revised:
10
03
2020
accepted:
18
03
2020
entrez:
29
4
2020
pubmed:
29
4
2020
medline:
29
4
2020
Statut:
epublish
Résumé
Cognitive-behavioural therapy (CBT) is effective in chronic fatigue syndrome. However, CBT has not been investigated in postinfectious chronic fatigue (CF), nor is it known whether addition of therapeutic elements from other disciplines might be feasible. We studied the feasibility of a combined CBT and music therapy intervention for CF following Epstein-Barr virus (EBV) infection in adolescents. Adolescents (12-20 years old) participating in a postinfectious cohort study who developed CF 6 months after an acute EBV infection were eligible for the present feasibility study. A combined CBT and music therapy programme (10 therapy sessions and related homework) was compared with care as usual in a randomised controlled design. Therapists and participants were blinded to outcome evaluation. Endpoints included physical activity (steps/day), symptom scores, recovery rate and possible harmful effects, but the study was underpowered regarding efficacy. Total follow-up time was 15 months. A total of 43 individuals with postinfectious CF were included (21 intervention group, 22 control group). Seven individuals left the study during the first 3 months, leaving 15 in the intervention group and 21 in the control group at 3 months' follow-up. No harmful effects were recorded, and compliance with appointment was high. In intention-to-treat analyses, number of steps/day tended to decrease (difference=-1158, 95% CI -2642 to 325), whereas postexertional malaise tended to improve (difference=-0.4, 95% CI -0.9 to 0.1) in the intervention group at 3 months. At 15 months' follow-up, there was a trend towards higher recovery rate in the intervention group (62% vs 37%). An intervention study of combined CBT and music therapy in postinfectious CF is feasible, and appears acceptable to the participants. The tendencies towards positive effects on patients' symptoms and recovery might justify a full-scale clinical trial. NCT02499302.
Sections du résumé
BACKGROUND
UNASSIGNED
Cognitive-behavioural therapy (CBT) is effective in chronic fatigue syndrome. However, CBT has not been investigated in postinfectious chronic fatigue (CF), nor is it known whether addition of therapeutic elements from other disciplines might be feasible. We studied the feasibility of a combined CBT and music therapy intervention for CF following Epstein-Barr virus (EBV) infection in adolescents.
METHODS
UNASSIGNED
Adolescents (12-20 years old) participating in a postinfectious cohort study who developed CF 6 months after an acute EBV infection were eligible for the present feasibility study. A combined CBT and music therapy programme (10 therapy sessions and related homework) was compared with care as usual in a randomised controlled design. Therapists and participants were blinded to outcome evaluation. Endpoints included physical activity (steps/day), symptom scores, recovery rate and possible harmful effects, but the study was underpowered regarding efficacy. Total follow-up time was 15 months.
RESULTS
UNASSIGNED
A total of 43 individuals with postinfectious CF were included (21 intervention group, 22 control group). Seven individuals left the study during the first 3 months, leaving 15 in the intervention group and 21 in the control group at 3 months' follow-up. No harmful effects were recorded, and compliance with appointment was high. In intention-to-treat analyses, number of steps/day tended to decrease (difference=-1158, 95% CI -2642 to 325), whereas postexertional malaise tended to improve (difference=-0.4, 95% CI -0.9 to 0.1) in the intervention group at 3 months. At 15 months' follow-up, there was a trend towards higher recovery rate in the intervention group (62% vs 37%).
CONCLUSION
UNASSIGNED
An intervention study of combined CBT and music therapy in postinfectious CF is feasible, and appears acceptable to the participants. The tendencies towards positive effects on patients' symptoms and recovery might justify a full-scale clinical trial.
TRIAL REGISTRATION NUMBER
UNASSIGNED
NCT02499302.
Identifiants
pubmed: 32342016
doi: 10.1136/bmjpo-2019-000620
pii: bmjpo-2019-000620
pmc: PMC7173952
doi:
Banques de données
ClinicalTrials.gov
['NCT02499302']
Types de publication
Journal Article
Retracted Publication
Langues
eng
Pagination
e000620Commentaires et corrections
Type : RetractionIn
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Am J Hosp Palliat Care. 2009 Oct-Nov;26(5):405-12
pubmed: 19820205
Cochrane Database Syst Rev. 2013 Dec 28;(12):CD006577
pubmed: 24374731
Brain Behav Immun. 2019 Jan;75:94-100
pubmed: 30261303
Psychol Rep. 2008 Dec;103(3):682-90
pubmed: 19320199
Lancet. 2011 Mar 5;377(9768):823-36
pubmed: 21334061
Psychother Psychosom. 2011;80(6):353-8
pubmed: 21829047
Cochrane Database Syst Rev. 2016 Feb 07;2:CD003200
pubmed: 26852189
JAMA Pediatr. 2014 Apr;168(4):351-60
pubmed: 24493300
Front Psychiatry. 2018 Dec 20;9:720
pubmed: 30618889
Lancet. 2017 Jul 22;390(10092):363-373
pubmed: 28648402
J Psychosom Res. 1998 Jul;45(1):53-65
pubmed: 9720855
J Health Psychol. 2017 Aug;22(9):1146-1154
pubmed: 28805516
Lancet Diabetes Endocrinol. 2017 Jun;5(6):448-456
pubmed: 28462869
Psychiatr Pol. 2015;49(5):1071-88
pubmed: 26688854
Arch Dis Child. 2018 Feb;103(2):155-164
pubmed: 28931531
Cochrane Database Syst Rev. 2011 Oct 05;(10):CD007103
pubmed: 21975762
Lancet. 2012 Apr 14;379(9824):1412-8
pubmed: 22385683
Br J Sports Med. 2006 Dec;40(12):992-7
pubmed: 16980531
Arch Dis Child. 2004 Jul;89(7):615-9
pubmed: 15210489
BMJ Paediatr Open. 2020 Apr 09;4(1):e000620
pubmed: 32342016
Cancer. 2017 Oct 1;123(19):3825-3834
pubmed: 28621820
Clin Psychol Psychother. 2013 Mar-Apr;20(2):107-17
pubmed: 21983916
Acta Psychiatr Scand. 1983 Jun;67(6):361-70
pubmed: 6880820
Pain. 2006 Mar;121(1-2):77-84
pubmed: 16480823
J Sleep Res. 2017 Oct;26(5):595-601
pubmed: 28470767
Health Qual Life Outcomes. 2006 Sep 14;4:61
pubmed: 16972987
J Pain Symptom Manage. 2002 Nov;24(5):517-25
pubmed: 12547051
J Pediatr Psychol. 1991 Feb;16(1):39-58
pubmed: 1826329
J Psychosom Res. 1993;37(2):147-53
pubmed: 8463991
Pediatrics. 2009 Jul;124(1):189-93
pubmed: 19564299
Chronobiol Int. 2008 Apr;25(2):333-48
pubmed: 18484368
Health Psychol Open. 2018 Oct 08;5(2):2055102918805187
pubmed: 30305916
BMJ. 2006 Sep 16;333(7568):575
pubmed: 16950834