title: The effects of cognitive behavioral therapy for postcancer fatigue on perceived cognitive disabilities and neuropsychological test performance.
abstract: BACKGROUND
  After successful cancer treatment, a substantial number of survivors continue to experience fatigue and related concentration and memory problems. Severe fatigue after cancer treatment can be treated effectively with cognitive behavioral therapy (CBT), but it is unclear whether CBT has an effect on cognitive functioning.
  
  
  OBJECTIVE
  We hypothesized that patients would report less cognitive disability after treatment with CBT for cancer-related fatigue. CBT was not expected to affect neuropsychological test performance, as it has been shown that fatigue is not associated with test performance.
  
  
  METHODS
  Data were used from a randomized controlled trial in which 98 severely fatigued cancer survivors, treated at least one year previously, were assessed at baseline (T1) and six months post-baseline (T2). Patients were randomly assigned to receive CBT (n = 50) or to a waiting list (WL) control condition (n = 48). Self-reported cognitive disability was assessed by the Concentration subscale of the Checklist Individual Strength and the Alertness Behavior subscale of the Sickness Impact Profile. Neuropsychological test performance was measured by the symbol digit modalities task and two reaction time tasks.
  
  
  RESULTS
  Patients who received CBT for post-cancer fatigue reported significantly less cognitive disability compared with those in the WL group. CBT also was associated with a clinically relevant reduction in concentration problems (CBT, 32% vs. WL, 2%). There were no significant differences in neuropsychological test performance between the CBT and WL groups.
  
  
  CONCLUSIONS
  CBT for post-cancer fatigue has already been shown to be an effective therapy. The present study demonstrates that CBT also may lead to a decrease in perceived cognitive disability.
authors.affiliation: Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: m.m.goedendorp@umcg.nl.
authors.forename: Martine M
authors.initials: MM
authors.lastname: Goedendorp
authors.affiliation: Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Knoop
authors.affiliation: Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Marieke F M
authors.initials: MF
authors.lastname: Gielissen
authors.affiliation: Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Constans A H H V M
authors.initials: CA
authors.lastname: Verhagen
authors.affiliation: Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Gijs
authors.initials: G
authors.lastname: Bleijenberg
mesh_terms: D000328:Adult; D001288:Attention; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D009483:Neuropsychological Tests; D057566:Self Report; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome
keywords: Cancer; cognitive behavioral therapy; cognitive disabilities; concentration; fatigue; neuropsychological functioning