Salivary cortisol output before and after cognitive behavioural therapy for chronic fatigue syndrome

Roberts, Amanda. D. L and Papadopoulos, Andrew S. and Wessely, Simon and Chalder, Trudie and Cleare, Anthony J. (2009) Salivary cortisol output before and after cognitive behavioural therapy for chronic fatigue syndrome. Journal of Affective Disorders, 115 (1-2). pp. 280-286. ISSN 0165-0327

Full content URL: http://dx.doi.org/10.1016/j.jad.2008.09.013

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Salivary cortisol output before and after CBT for CFS

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Abstract

Background: There is evidence that patients with chronic fatigue syndrome (CFS) have mild hypocortisolism. One theory about the aetiology of this hypocortisolism is that it occurs late in the course of CFS via factors such as inactivity, sleep disturbance, chronic stress and deconditioning. We aimed to determine whether therapy aimed at reversing these factors – cognitive behavioural therapy for CFS – could increase cortisol output in CFS.
Methods: We measured diurnal salivary cortisol output between 0800 and 2000h before and after 15 sessions (or 6 months) of CBT in 41 patients with CDC-defined CFS attending a specialist, tertiary outpatient clinic.
Results: There was a significant clinical response to CBT, and a significant rise in salivary cortisol output after CBT.
Limitations: We were unable to control for the passage of time using a non-treated CFS group.
Conclusions: Hypocortisolism in CFS is potentially reversible by CBT. Given previous suggestions that lowered cortisol may be a maintaining factor in CFS, CBT offers a potential way to address this.

Keywords:Chronic fatigue syndrome, Myalgic encephalomyelitis, Cognitive behavioural therapy, HPA axis, Cortisol, Neuroendocrinology, oaopen
Subjects:A Medicine and Dentistry > A300 Clinical Medicine
C Biological Sciences > C841 Health Psychology
Divisions:College of Social Science > School of Psychology
ID Code:15847
Deposited On:30 Oct 2014 17:48

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