The role of the partner and relationship satisfaction on treatment outcome in patients with chronic fatigue syndrome.
BACKGROUND
Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) leads to a significant decrease in CFS-related symptoms and disability. The primary objective of this study was to explore whether partners' solicitous responses and patients' and partners' perceived relationship satisfaction had an effect on treatment outcome.


METHODS
The treatment outcome of a cohort of 204 consecutively referred patients treated with CBT was analysed. At baseline, CFS patients completed the Maudsley Marital Questionnaire. The Checklist Individual Strength subscale Fatigue and the Sickness Impact Profile total scores completed by CFS patients post-treatment were used as measures of clinically significant improvement. Partners completed the Family Response Questionnaire, the Maudsley Marital Questionnaire, the Brief Illness Perception Questionnaire, and the Causal Attribution List. Logistic regression analyses were performed with clinically significant improvement in fatigue and disability as dependent variables and scores on questionnaires at baseline as predictors.


RESULTS
Solicitous responses of the partner were associated with less clinically significant improvement in fatigue and disability. Partners more often reported solicitous responses when they perceived CFS as a severe condition. Patients' relationship dissatisfaction was negatively associated with clinically significant improvement in fatigue.


CONCLUSIONS
Partners' solicitous responses and illness perceptions at the start of the therapy can negatively affect the outcome of CBT for CFS. We emphasize the importance of addressing this in therapy.
Expert Centre for Chronic Fatigue, Radboud University Medical Centre,Nijmegen,The Netherlands.
J
J
Verspaandonk
Faculty of Social and Behavioural Sciences,Utrecht University,The Netherlands.
M
M
Coenders
Expert Centre for Chronic Fatigue, Radboud University Medical Centre,Nijmegen,The Netherlands.
G
G
Bleijenberg
Faculty of Clinical Psychological Science,Maastricht University,The Netherlands and RINO Zuid,Postdoctoral Education Institute,Eindhoven,The Netherlands.
J
J
Lobbestael
Expert Centre for Chronic Fatigue, Radboud University Medical Centre,Nijmegen,The Netherlands.
H
H
Knoop
D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D015673:Fatigue Syndrome, Chronic / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012720:Severity of Illness Index; D012747:Sexual Partners / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
Chronic fatigue syndrome; cognitive behavioural model; cognitive behavioural therapy; illness perceptions; partner relationship; partners' responses; relationship satisfaction; social support