Chronic fatigue is a major problem in MS; it’s the commonest symptom PwMS complain about (~85%) and in patients with fatigue ~50% claim it be their most disabling symptom. A randomized controlled trial has shown that cognitive behavioural therapy (CBT) is more effective in reducing MS fatigue than relaxation training (RT). This study analysed additional data from this trial . Results: avoidance behaviour and three cognitive variables (symptom focusing, believing symptoms are a sign of damage and a negative representation of fatigue) improved significantly more in the CBT than the RT group. Changing negative representations of fatigue mediated the decrease in severity of fatigue. Conclusions: Change in beliefs about fatigue play a crucial role in CBT for MS-related fatigue.
Knoop et al. Psychol Med. 2011 Jun 15:1-9. [Epub ahead of print]
“If you suffer from severe MS-related fatigue you should look into CBT; some of my patients have had good responses. This paper attempts to define which patients are likely to respond to CBT. I wish we knew more about MS-related fatigue; I would rate the treatment of MS-related fatigue as one of the biggest unmet needs in MS. Do you agree?”