Do adolescents with chronic fatigue syndrome (CFS/ME) and co-morbid anxiety and/or depressive symptoms think differently to those who do not have co-morbid psychopathology?

Effects of the Prolong Life With Nine Turn-Method Qigong on Fatigue, Insomnia, Anxiety, and Gastrointestinal Disorders in Patients With Chronic Fatigue Syndrome: Protocol for a Randomized Controlled Trial

BACKGROUND

Chronic fatigue syndrome (CFS) is a debilitating multisystem disorder that can lead to various pathophysiological abnormalities and symptoms, including insomnia, gastrointestinal disorders, and anxiety. Due to the side effects of currently available drugs, there is a growing need for safe and effective nondrug therapies. The Prolong Life With Nine Turn (PLWNT) Qigong method is a system of mind-body exercise with restorative benefits that can alleviate the clinical symptoms of CFS and impart a significant inhibitory effect. Various studies have proven the treatment efficacy of PLWNT; however, the impact on insomnia, gastrointestinal disorders, and anxiety in patients with CFS has not yet been investigated.

OBJECTIVE

This study aims to evaluate the efficacy and safety of the PLWNT method in terms of its effects on fatigue, insomnia, anxiety, and gastrointestinal symptoms in patients with CFS.

METHODS

We will conduct a randomized, analyst-blinded, parallel-controlled trial with a 12-week intervention and 8-week follow-up. A total of 208 patients of age 20-60 years will be recruited. The patients will be randomly divided into a PLWNT Qigong exercise group (PLWNT Group) and a control group treated with cognitive behavioral therapy at a ratio of 1:1. Participants from the treatment groups will be taught by a highly qualified professor at the Shanghai University of Traditional Chinese Medicine once a week and will be supervised via web during the remaining 6 days at home, over 12 consecutive weeks. The primary outcome will be the Multidimensional Fatigue Inventory 20, while the secondary outcomes include the Pittsburgh Sleep Quality Index, Gastrointestinal Symptom Rating Scale, Hospital Anxiety and Depression Scale, functional magnetic resonance imaging, gut microbiota, and peripheral blood.

RESULTS

The study was approved by the ethics committee of Shanghai Municipal Hospital of Traditional Chinese Medicine in March 2022 (Ethics Approval Number 2022SHL-KY-05). Recruitment started in July 2022. The intervention is scheduled to be completed in December 2024, and data collection will be completed by the end of January 2025. Over the 3-year recruitment period, 208 participants will be recruited. Data management is still in progress; therefore, data analysis has yet to be performed.

CONCLUSIONS

This randomized trial will evaluate the effectiveness of the PLWNT method in relieving fatigue, insomnia, anxiety, and gastrointestinal symptoms in patients with CFS. If proven effective, it will provide a promising alternative intervention for patients with CFS.

TRIAL REGISTRATION

China Clinical Trials Registry ChiCTR2200061229; https://www.chictr.org.cn/showproj.html?proj=162803.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/53347.

A description of the current status of chronic fatigue syndrome and associated factors among university students in Wuhan, China

Introduction

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a group of chronic conscious fatigue that is not easily relieved by rest and is accompanied by corresponding physiological dysfunction and psychological symptoms. However, due to the insufficient understanding of the pathogenesis of ME/CFS, there is currently a lack of effective treatment methods. In addition, there are few surveys on the current status of ME/CFS in the central region of China, and the data on ME/CFS among university students in the central region are lacking. This group conducted a survey on university students in Wuhan, Hubei Province in 2022 to collect and analyze the current status of ME/CFS among university students in central China for the first time, aiming to understand the current development of ME/CFS among university students, investigate the influencing factors of its prevalence, fill the data gaps, and provide a reliable basis for developing interventions for chronic fatigue syndrome among university students.

Methods

A cross-sectional study was conducted among university students in a university in Hubei province. Data were collected via online questionnaire surveys. The contents included demographic characteristics, lifestyles, disease history, depression, anxiety, sleep, ME/CFS and other associated factors. SAS 9.4 statistical software was used to analyze and estimate the effect of associated factors on ME/CFS.

Results

A total of 1826 subjects were included in the final analysis. The results showed that the prevalence of ME/CFS in university students was 6.25%. Univariate analysis showed that exercise, alcohol consumption, study, overnights, diet, anxiety, depression, and sleep quality were associated with ME/CFS (P < 0.05). Multivariate analysis showed that overnights, overeating, anxiety, and sleep quality were independent risk factors, while learning was a protective factor.

Conclusion

College students should pay enough attention to ME/CFS, improve their understanding of ME/CFS, and improve people's ability to understand ME/CFS.

Fatigue severity and avoidance among individuals with chronic disease: A meta-analysis

OBJECTIVE

Fatigue is a common, debilitating symptom experienced by individuals with chronic disease. Avoidance, or the act of evading unwanted experiences, is associated with fatigue across chronic disease samples. The current study sought to determine the strength of association between fatigue severity and avoidance in individuals with chronic disease.

METHODS

PubMed, PsycINFO, CINAHL, and ProQuest Dissertations and Theses databases were searched. Eligible studies measured fatigue and avoidance in chronic disease samples. Sixty-six studies were included. Data analyses were conducted in Rstudio. A random effects model was employed, and a weighted mean effect size was computed for fatigue severity and avoidance. Mixed-effects meta-regression analyses were conducted to examine moderating variables, including patient, clinical, and measurement characteristics. Publication bias was examined using funnel plot, trim-and-fill, and p-curve.

RESULTS

The meta-analysis comprised of 71 unique patient samples from 66 studies. The total number of included participants was 13,024. A small, positive association was found between fatigue severity and avoidance, r(71) = 0.22, p < .001, 95% CI [0.18-0.27], SE = 0.02. There was also significant heterogeneity, Q(70) = 349.96, p < .001. Moderator analyses examining age, sex, illness duration, avoidance type, and disease sample were all non-significant. Regarding publication bias, trim-and-fill resulted in a modified weighted mean effect size (r(83) = 0.18, p < .001) and a p-curve analysis supported the evidential value of the current analysis.

CONCLUSION

Findings support that among individuals with chronic disease, fatigue severity and avoidance are positively associated, which has implications for behavioral interventions in this population.

Propiedades psicométricas del Children's Negative Cognitive Error Questionnaire en población española adolescente y joven

El objetivo de este estudio era analizar las propiedades psicométricas de la versión española del Children’s Negative Cognitive Errors Questionnaire (CNCEQ) en una muestra de población joven. El CNCEQ es uno de los procedimientos de autoinforme más utilizados para medir cuatro tipos de distorsión cognitiva (pensamiento catastrófico, sobregeneralización, personalización y abstracción selectiva) en tres áreas de contenido (social, académica y deportiva). A pesar de ello, no existen estudios que analicen las propiedades del instrumento entre los jóvenes. El estudio utilizó una amplia muestra (N = 2040; entre 12 y 22 años; 50,7% hombres y 47,3% mujeres) de diferentes centros educativos. La validez de constructo se evaluó mediante un análisis factorial exploratorio, y la consistencia interna mediante el coeficiente alfa de Cronbach. También se realizaron contrastes de medias para evaluar la validez discriminante y se llevó a cabo un análisis de correlación y regresión para explorar la validez de criterio. Los resultados indican que el CNCEQ permite evaluar las distorsiones cognitivas autodegradantes entre los jóvenes con suficientes garantías psicométricas. Su uso por parte de los profesores les permitirá adaptar sus actividades para tener en cuenta la presencia de distorsiones cognitivas entre sus estudiantes.

Exploring anhedonia in adolescents with Chronic Fatigue Syndrome (CFS): A mixed-methods study

BACKGROUND

Chronic Fatigue Syndrome (CFS/ME) may get in the way of enjoying activities. A substantial minority of adolescents with CFS/ME are depressed. Anhedonia is a core symptom of depression. Anhedonia in adolescents with CFS/ME has not been previously investigated.

METHOD

One hundred and sixty-four adolescents, age 12 to 18, with CFS/ME completed a diagnostic interview (K-SADS) and questionnaires (HADS, RCADS). We used a mixed-methods approach to explore the experience of anhedonia and examine how common it is, comparing those with clinically significant anhedonia to those without.

RESULTS

Forty-two percent of adolescents with CFS/ME reported subclinical or clinical levels of anhedonia. Fifteen percent had clinically significant anhedonia. Thematic analysis generated two themes: (1) stopping activities that they previously enjoyed and (2) CFS/ME obstructs enjoyment. Most (72%) of those who reported clinically significant anhedonia met the depression diagnostic criteria. Those who were depressed used more negative language to describe their experience of activities than in those who were not depressed, although the themes were broadly similar.

CONCLUSIONS

Experiencing pleasure from activities may be affected in CFS/ME, particularly in those who are depressed. Anhedonia may get in the way of behavioural strategies used within CFS/ME treatments.