title: Treatment expectations influence the outcome of multidisciplinary rehabilitation treatment in patients with CFS.
abstract: OBJECTIVE
  To improve the effectiveness of treatment in patients with chronic fatigue syndrome it is worthwhile studying factors influencing outcomes. The aims of this study were (1) to assess the association of expectancy and credibility on treatment outcomes, and (2) to identify baseline variables associated with treatment expectancy and credibility.
  
  
  METHODS
  122 patients were included in a randomized controlled trial of whom 60 received cognitive behavioural therapy (CBT) and 62 multidisciplinary rehabilitation treatment (MRT). Expectancy and credibility were measured with the credibility and expectancy questionnaire. Outcomes of treatment, fatigue, and quality of life (QoL), were measured at baseline and post-treatment. Multiple linear regressions were performed to analyse associations.
  
  
  RESULTS
  In explaining fatigue and the physical component of the QoL, the effect of expectancy was significant for MRT, whereas in CBT no such associations were found. The main effect of expectancy on the mental component of QoL was not significant. For credibility, the overall effect on fatigue and the physical component of QoL was not significant. In explaining the mental component of QoL, the interaction between treatment and credibility was significant. However, the effects within each group were not significant. In the regression model with expectancy as dependent variable, only treatment centre appeared significantly associated. In explaining credibility, treatment centre, treatment allocation and depression contributed significantly.
  
  
  CONCLUSIONS
  For clinical practice it seems important to check the expectations of the patient, since expectations influence the outcome after MRT.
authors.affiliation: Revant Rehabilitation Centre Breda, Brabantlaan 1, 4817 JW Breda, The Netherlands. Electronic address: d.vos@revant.nl.
authors.forename: D C W M
authors.initials: DC
authors.lastname: Vos-Vromans
authors.affiliation: Department of Rehabilitation Medicine, Research School CAPHRI Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Rehabilitation Medicine, Academic Hospital Maastricht, P.O. Box 5800, 6202 ZA Maastricht, The Netherlands; Adelante Centre of Expertise in Rehabilitation and Audiology, P.O. Box 88, 6430 AB Hoensbroek, The Netherlands.
authors.forename: I P J
authors.initials: IP
authors.lastname: Huijnen
authors.affiliation: Revant Rehabilitation Centre Breda, Brabantlaan 1, 4817 JW Breda, The Netherlands.
authors.forename: L J M
authors.initials: LJ
authors.lastname: Rijnders
authors.affiliation: Department of Methodology and Statistics, Research School CAPHRI, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Winkens
authors.affiliation: Department of General Practice, Research School CAPHRI, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Knottnerus
authors.affiliation: Department of Rehabilitation Medicine, Research School CAPHRI Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; Department of Rehabilitation Medicine, Academic Hospital Maastricht, P.O. Box 5800, 6202 ZA Maastricht, The Netherlands; Adelante Centre of Expertise in Rehabilitation and Audiology, P.O. Box 88, 6430 AB Hoensbroek, The Netherlands.
authors.forename: R J E M
authors.initials: RJ
authors.lastname: Smeets
mesh_terms: D000328:Adult; D001290:Attitude; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D015673:Fatigue Syndrome, Chronic / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: CFS; Credibility; Expectancy; Fatigue; Outcome; Quality of life