Affiliations: Department of Pediatrics, Faculty of Medicine,
Mansoura University, Mansoura, Egypt | Department of Psychiatry, Faculty of Medicine,
Mansoura University, Mansoura, Egypt | Department of Neurology, Faculty of Medicine, Mansoura
University, Mansoura, Egypt
Note: [] Correspondence: M.S. Al-Haggar, MD, Department of Pediatrics,
Faculty of Medicine, Mansoura University, Mansoura, Egypt. Postal address: P.O.
732 Al-Khobar 31952, Saudi Arabia. Tel.: +966 38982022; Fax: +966 38951196;
E-mail: [email protected]
Abstract: We aimed to evaluate the efficacy of cognitive behavioral therapy
(CBT) aided by biofeedback in rehabilitating Egyptian adolescents who were
suffering from chronic fatigue syndrome (CFS). Out of 298 screened individuals
with chronic fatigue, only 159 adolescents were eligible for study; of them 63
cases lost follow up and four cases were further excluded because of switch
leaving only 92 cases with complete database. Age range of enrolled cases was
10–14 years and male/female ratio (1/2.5). They were recruited from
private schools and polyclinics in Eastern province, Saudi Arabia; some cases
were referred by psychiatrists in private hospitals of the same area. All cases
were diagnosed as CFS according to the recommendations of International CFS
Study Group. Patients were randomly allocated to one of two groups;
interventional group comprised 50 cases and underwent CBT aided with
biofeedback over a period of 18 months applying two protocols according to
patient's activity pattern. Forty-two cases were followed and treated
symptomatically and used as control group. Data were processed and analyzed
using SPSS version 10.0. The most common symptoms were unrefreshing sleep,
headache and myalgia (95.8%, 67.7% and 50% respectively). Patients of
interventional group showed marked improvement manifested by decrement of
checklist individual strength (decreased 23.1%; 95% confidence interval
19.2–25.4%) and better school attendance (increased 31.5%; 95% confidence
interval 29.8–36.6 hours/month) with the disappearance of some self-rated
CFS symptoms. CBT aided by biofeedback could be very effective in treatment of
adolescents suffering from CFS taking in consideration the stressors and
precipitating factors during settings of psychotherapy.
