Non-pharmacological treatment options for fatigue: A systematic review of RCTs in adults

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-02-28 DOI:10.1016/j.jpsychores.2025.112084

Carlotta Steen , Anna Zalpur , Marissa Bentele , Stephan Zipfel , Andreas Stengel

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引用次数: 0

Abstract

Objective

Fatigue is a significant contributor to the burden experienced by patients with chronic disorders. The development of standardized treatments is challenging due to the lack of consensus concerning the etiology of fatigue. The aim of this systematic review is to provide an overview of non-pharmacological interventions for fatigue. The efficacy and differences in fatigue treatment across conditions will be explored.

Methods

A systematic literature search was conducted using the databases PubMed, Web of Science, PsycInfo and CINAHL.

Trials were eligible when (1) adult patients (≥ 18 years old) with disorders causing fatigue were included, (2) non-pharmacological interventions performed, (3) treatment was compared to standard care, placebo or active control group, (4) fatigue was the only primary outcome assessed with a multidimensional tool, and (5) a randomized controlled trial (RCT) design was applied.

Results

7592 papers were screened. 91 RCTs were eligible, with data reported in 95 papers. Specific fatigue interventions were present for a broad range of conditions. Findings demonstrated promising evidence for physical activity, CBT, online programs and multidimensional modules. Additional types of interventions were effective, but evidence was limited due to risk of bias and small sample sizes. Due to high heterogeneity concerning methodology, a meta-analysis was not possible.

Conclusion

Several non-pharmacological treatment options for fatigue are promising. No clear evidence was found that fatigue should be treated differently depending on the underlying condition. However, further research is necessary with a focus on a transdiagnostic approach to fatigue, high study quality and long-term follow-ups.

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疲劳的非药物治疗选择：成人随机对照试验的系统回顾

目的：疲劳是慢性疾病患者负担的重要因素。由于对疲劳的病因缺乏共识，标准化治疗的发展具有挑战性。本系统综述的目的是提供非药物干预疲劳的概述。将探讨不同条件下疲劳治疗的疗效和差异。方法采用PubMed、Web of Science、PsycInfo、CINAHL等数据库进行系统的文献检索。当(1)纳入有导致疲劳的疾病的成年患者（≥18岁），(2)进行非药物干预，(3)将治疗与标准治疗、安慰剂或积极对照组进行比较，(4)疲劳是唯一的主要结局，用多维工具评估，(5)采用随机对照试验（RCT）设计。结果共筛选论文7592篇。91项随机对照试验符合条件，95篇论文报告了数据。具体的疲劳干预措施存在于广泛的条件。研究结果显示，体育活动、认知行为疗法、在线课程和多维模块都有很好的效果。其他类型的干预措施是有效的，但由于存在偏倚风险和样本量小，证据有限。由于方法的高度异质性，不可能进行荟萃分析。结论疲劳的几种非药物治疗方案是有希望的。没有明确的证据表明，疲劳应该根据潜在的条件而不同地对待。然而，进一步的研究是必要的，重点是疲劳的跨诊断方法，高质量的研究和长期随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.