TGI Friday! Our weekly round-up of recently published research abstracts and other items | 10 January 2014

January 10, 2014

From Trials, 26 December 2013 [Epub ahead of print]

Comparing specialist medical care with specialist medical care plus the Lightning Process(R) for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised controlled trial (SMILE Trial).

Crawley E, Mills N, Hollingworth W, Deans Z, Sterne JA, Donovan JL, Beasant L, Montgomery A.



Chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a relatively common and potentially serious condition with a limited evidence base for treatment. Specialist treatment for paediatric CFS/ME uses interventions recommended by National Institute for Health and Clinical Excellence (NICE) including cognitive behavioural therapy, graded exercise therapy and activity management.

The Lightning Process(R) (LP) is a trademarked intervention derived from osteopathy, life-coaching and neuro-linguistic programming, delivered over three consecutive days as group sessions. Although over 250 children with CFS/ME attend LP courses each year, there are no reported studies on the effectiveness or cost-effectiveness.


This pragmatic randomised controlled trial is set within a specialist paediatric CFS/ME service in the south west of England. Children and young people with CFS/ME (n = 80 to 112), aged 12 to 18 years old will be randomised to specialist medical care (SMC) or SMC plus the LP. The primary outcome will be physical function (SF-36 physical function short form) and fatigue (Chalder Fatigue Scale).


This study will tell us whether adding the LP to SMC is effective and cost-effective compared to SMC alone. This study will also provide detailed information on the implementation of the LP and SMC.Trial registration: Current Controlled Trials ISRCTN81456207 (31 July 2012).

From Health Care for Women International, January 2014

A qualitative natural history study of ME/CFS in the Community

Valerie R. Anderson(a), Leonard A. Jason(b) & Laura E. Hlavaty(b)
a) Department of Psychology, Michigan State University, East Lansing, Michigan, USA
b) Department of Psychology, DePaul University, Chicago, Illinois, USA


In previous qualitative research on Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS), researchers have focused on the experiences of patients with ME/CFS in tertiary care samples. This qualitative study examined the natural history of people with ME/CFS (n=19) from a community-based sample.

Findings highlighted multilayered themes involving the illness experience and the physical construction of ME/CFS.

In addition, this study further illuminated unique subthemes regarding community response and treatment, which have implications for understanding the progression of ME/CFS as well as experiences of those within patient networks. There is a need for more longitudinal qualitative research on epidemiological samples of patients with ME/CFS.

From Journal of Clinical Nursing, e-published on 20 December 2013

‘Sometimes it feels as if the world goes on without me': adolescents' experiences of living with chronic fatigue syndrome

Anette Winger (1,2), Mirjam Ekstedt(3,4), Vegard B Wyller(5,6,7), Solvi Helseth(8,9)
1) Faculty of Nursing, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
2) Medical Faculty, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
3) KTH, Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden
4) Center for Shared Decision Making and Collaborative Care, Oslo University Hospital, Oslo, Norway
5) Department of Pediatrics, Oslo University Hospital, Oslo, Norway
6) Division of Medicine Laboratory Sciences, Medical Faculty, University of Oslo, Oslo, Norway
7) Department of Pediatrics, Akershus University Hospital, Lorenskog, Norway
8) Faculty of Nursing, Oslo University College of Applied Sciences, Oslo, Norway
9) Department of Health and Nursing Science, University of Agder, Grimstad, Norway
* Correspondence: Anette Winger, PhD Student, Faculty of Nursing, Oslo and Akershus University College of Applied Sciences, Postboks 4 St. Olavs plass, Oslo NO-0130, Norway. Telephone: +47 67236212. E-mail:


Aims and objectives: To explore the experience of being an adolescent with chronic fatigue syndrome.


Despite ample research, chronic fatigue syndrome is still poorly understood, and there are still controversies related to the illness. Adolescents with chronic fatigue syndrome are often unable to attend school and lose social relations with friends. The challenges they face will affect their quality of life.


A qualitative, phenomenological hermeneutical design.


Six boys and twelve girls, aged 12-18, were interviewed, emphasising their own experiences living with chronic fatigue syndrome. Analyses were performed using a phenomenological hermeneutical method.


The core theme, ‘Sometimes it feels as if the world goes on without me', encompasses the feelings an adolescent living with chronic fatigue syndrome might have about life. The core theme was supported by four subthemes: ‘On the side of life – locked in and shut out'; ‘the body, the illness and me'; ‘if the illness is not visible to others, does it exist?'; and ‘handling life while hoping for a better future'. The subthemes reflect the experience of social isolation, their own and others' understanding of the illness and hope for the future.


Not being able to be with friends, or attend school, made the adolescents feel different and forgotten. They felt alienated in their own bodies and were struggling to be visible to themselves and to their surroundings. Spending less time with friends and more time with their parents constituted a threat to independence and development. Yet they managed to envision a better future despite all the difficulties.


To provide effective support and constructive relations to adolescents with chronic fatigue syndrome, all health professions involved need insight from the persons who are themselves ill. Health centres could function as resource centres for patients and healthcare professionals.

From Health Psychology and Behavioral Medicine, epublished 2 January 2014.

Predictors of post-infectious chronic fatigue syndrome in adolescents

Leonard A. Jason*, Ben Z. Katz, Yukiko Shiraishi, Cynthia J. Mears, Young Im & Renee R. Taylor


This study focused on identifying risk factors for adolescent post-infectious chronic fatigue syndrome (CFS), utilizing a prospective, nested case–control longitudinal design in which over 300 teenagers with infectious mononucleosis (IM) were identified through primary care sites and followed. Baseline variables that were gathered several months following IM, included autonomic symptoms, days in bed since IM, perceived stress, stressful life events, family stress,
difficulty functioning and attending school, family stress, and psychiatric disorders.

A number of variables were predictors of post-infectious CFS at six months; however, when autonomic symptoma were used as a control variable, only days spent in bed since mono was a significant predictor. Step-wise logistic regression findings indicated that baseline autonomic symptoms as well as days spent in bed since mono, which reflect the severity of illness, were the only significant predictors of those who met CFS criteria at six months.

From Reumatologia Clinica, 2013 (issue not found).

Letter to the Editor

Etiology of sicca syndrome in a consecutive series of 199 patients with chronic fatigue syndrome

(Editorial note: The dryness of the eyes, mouth and other body parts is known as sicca syndrome).

Rami Qanneta(a,∗), Ramon Fontova(b), Anna Pàmies(b)
a) Chronic Fatigue Unit, Department of Rheumatology, Hospital Universitari Joan XXIII, Tarragona, Spain
b) Department of Rheumatology, Hospital Universitari Joan XXIII, Tarragona, Spain
∗) Corresponding author. E-mail address: rami (R. Qanneta)

Abstract not available but full text of letter is available by clicking on the link.

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