Medically unexplained physical symptoms - CFS
13 important questions on Medically unexplained physical symptoms - CFS
What is chronic fatigue syndrome?
What are common diagnostic criteria for CFS?
- Definite onset
- Idiopathic fatigue
- Reduction in previous activity (>50%)
- Fatigue of at least 6 months
- Exclusion: not due to another medical or psychiatric disorder (excluding anxiety, depression).
What are risk factors for a poor prognosis?
- Older age
- psychiatric co-morbidity
- somatic illness attributions
- Longer illness duration
- more severe fatigue
- Higher grades + faster learning
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What is the 4P model for CFS?
- predisposing
- precipitating
- perpetuating
- Prognostic factors
What does the model of perpetuating factors of Vercoulen state?
- Stress the importance of cognitions:
- Sense of control: To what extent does the patient have the feeling that he/she can control the fatigue?
- Attribution: psychiological, somatic or mixed
- Focus: attention
Out of which predisposing factors, precipitating factors and perpetuating factors does the complex CBT model for CFS consists?
2 cycles of cognitive behavioural cycli of perpetuating factors. Switching between the two cycles is a reason for the perpetuating effect.
What are the important points of the complex CBT model of CFS?
- Predisposing core beliefs are as important as precipitating (triggers) and perpetuating factors
- Based on two interactive cognitive behavioural cycli
- The alternation between the two cycli results in perpetuating of fatigue
Explain the vicious circle of the switching between the two cognitive behavioural cycli of CFS patients that perpetuate the fatigue ![]()
Wat zijn therapievormen die gebruikt kunnen worden op gedragsvlak bij CFS?
- Focus op Activity scheduling
- Avoidance of activity vermijden (prolonged rest)
- outburst of activity vermijden
What is the difference between activity scheduling and behavioural activation?
Activity scheduling in CFS, gaat puur om het verhogen van activiteit.
How is activity scheduling implemented in treatment of patients with CFS?
- Start with self-monitoring of baseline activity and rest (very specific what did you do?) and note fatigue level.
- Planning of activity and rest (set LT and weekly goals). "spend 15 minutes on househol chores"
What is the difference in focus in treatment between active/passive CFS patients?
- Focus on finding balance
- underlying perfectionistics cognitions
Passive CFS
- Focus on underlying avoidance cognitions
- increase activity and decrease rest
Which therapies formes are most effective in the treatment of CFS patients? CBT, Graded exercise, paced exercise?
CBT has an advantage for patients with co-morbid depression or anxiety.
*paced exercise = paced to ability of patients
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