title: Solution focused therapy: a promising new tool in the management of fatigue in Crohn's disease patients psychological interventions for the management of fatigue in Crohn's disease.
abstract: BACKGROUND
  Crohn's disease patients have a decreased Quality of Life (QoL) which is in part due to extreme fatigue. In a pilot study we prospectively assessed the feasibility and effect of psychological interventions in the management of fatigue.
  
  
  METHODS
  Patients with quiescent Crohn's disease and a high fatigue score according to the Checklist Individual Strength were randomized to Problem Solving Therapy (PST), Solution Focused Therapy (SFT) or to a control group (treatment as usual, TAU). Patients completed the Inflammatory Bowel Disease Questionnaire, the EuroQol-5D, and the Trimbos questionnaire for Costs.
  
  
  RESULTS
  Twenty-nine patients were included (12 TAU, 9 PST, 8 SFT), of these 72% were female, mean age was 31 years (range 20-50). The SFT group improved on the fatigue scale in 85.7% of the patients, in the PST group 60% showed improved fatigue scores and in the TAU group 45.5%. Although not significant, in both intervention groups the QoL increased. Medical costs lowered in 57.1% of the patients in the SFT group, in the TAU 45.5% and the in PST group 20%. The drop out rate was highest in the PST group (44%; SFT 12.5%; TAU 8.3%).
  
  
  CONCLUSIONS
  PST and SFT both positively affect the fatigue and QoL scores in patients with Crohn's disease. SFT seems most feasible with fewer dropouts and is therefore a promising new tool in the management of fatigue in Crohn's disease patients.
authors: Department of Gastroenterology and Hepatology, Erasmus MC, Rotterdam, The Netherlands. l.vogelaar@erasmusmc.nl
authors: Lauran
authors: L
authors: Vogelaar
authors: Adriaan
authors: A
authors: Van't Spijker
authors: Ton
authors: T
authors: Vogelaar
authors: Jan J
authors: JJ
authors: van Busschbach
authors: Martijn S
authors: MS
authors: Visser
authors: Ernst J
authors: EJ
authors: Kuipers
authors: C Janneke
authors: CJ
authors: van der Woude
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003424:Crohn Disease / Q000150:complications / Q000523:psychology*; D005221:Fatigue / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011340:Problem Solving; D011446:Prospective Studies; D011613:Psychotherapy / Q000191:economics; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult