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Biomedical subjects

C Surawy

Publications and source records attributed to C Surawy.

6 recordsLinked to original sources
PubMed1996

Cognitive behaviour therapy for the chronic fatigue syndrome: a randomized controlled trial.

OBJECTIVE: To evaluate the acceptability and efficacy of adding cognitive behaviour therapy to the medical care of patients presenting with the chronic fatigue syndrome. DESIGN: Randomised controlled trial with final assessment at 12 months. SETTING: An infectious diseases outpatient clinic. SUBJECTS: 60 consecutively referred patients meeting consensus criteria for the chronic fatigue syndrome. INTERVENTIONS: Medical care comprised assessment, advice, and follow up in general practice. Patients who received cognitive behaviour therapy were offered 16 individual weekly sessions in addition to their medical care. MAIN OUTCOME MEASURES: The proportions of patients (a) who achieved normal daily functioning (Karnofsky score 80 or more) and (b) who achieved a clinically significant improvement in functioning (change in Karnofsky score 10 points or more) by 12 months after randomisation. RESULTS: Only two eligible patients refused to participate. All randomised patients completed treatment. An intention to treat analysis showed that 73% (22/30) of recipients of cognitive behaviour therapy achieved a satisfactory outcome as compared with 27% (8/30) of patients who were given only medical care (difference 47 percentage points; 95% confidence interval 24 to 69). Similar differences were observed in subsidiary outcome measures. The improvement in disability among patients given cognitive behaviour therapy continued after completion of therapy. Illness beliefs and coping behaviour previously associated with a poor outcome changed more with cognitive behaviour therapy than with medical care alone. CONCLUSION: Adding cognitive behaviour therapy to the medical care of patients with the chronic fatigue syndrome is acceptable to patients and leads to a sustained reduction in functional impairment.

Adaptation, Psychological↗
PubMed1995

Chronic fatigue syndrome: a cognitive approach.

Observations concerning the characteristics of patients who presented to a medical clinic with a principal complaint of chronic medically unexplained fatigue (Chronic Fatigue Syndrome or CFS) are described, including the cognitions (thoughts and assumptions) elicited from a sample of these patients who were treated using cognitive behavioural therapy. On the basis of these observations a cognitive theory of the aetiology of CFS is proposed. These observations have implications for the treatment of patients with CFS.

Adaptation, Psychological↗
PubMed1994

Why do doctors find some patients difficult to help?

Almost all doctors encounter difficulties in managing some patients. Previous studies have examined the characteristics of such patients: we have additionally studied the reasons why hospital doctors find these patients 'difficult to help'. Three clinics (two medical and one surgical) were studied. The consultants rated 60 (22%) of 293 attenders s severely or extremely difficult to help. Difficulty was associated with greater patient distress (odds ratio 3.9; 95% CI 2.0-7.7), less patient satisfaction (2.6; 1.3-5.0) and chronic attendance (5.0; 1.4-17.3). An interview study of 40 'difficult' patients indicated that doctors considered psycho-social factors more important in difficult patients (3.2; 1.3-7.7). Objective differences between the doctor's and the patient's aims for care also occurred more frequently for difficult patients (2.8; 1.1-7.2). Three common types of difficulty were identified; medically unexplained symptoms; co-existing social problems; and severe untreatable illness. A review of the management aims for patients whom doctors find 'difficult to help', combined with improved access to psycho-social care, could improve both the quality and the cost-effectiveness of hospital out-patient services.

Adolescent↗
PubMed1989

Knowledge about diabetes in type 1 patients is related to metabolic control.

Twenty-five Type 1 diabetic patients and their spouses attending a diabetes clinic completed the recently developed CCQ-1 questionnaire, which assesses knowledge about the disease. Questionnaires were completed in the presence of a clinical psychologist. Glycosylated haemoglobin concentration was inversely correlated with patient scores for general management (r = -0.69, p less than 0.001), insulin (r = -0.66, p less than 0.001), home monitoring (r = -0.53, p less than 0.01), and overall knowledge (r = -0.55, p less than 0.01), but not for diet and footcare. No association was found between patients' metabolic control and scores among spouses, who knew significantly less about the disease than the patients themselves. The strength of the associations found supports the use of well-designed psychological instruments in diabetes research.

Adult↗
PubMed1986

Smoking behaviour under conditions of relaxation: a comparison between types of smokers.

Smoking behaviour, self-reported mood and cardiac activity were examined in 12 "sedative" and 12 "stimulant" smokers, defined using Mangan and Golding's questionnaire. This concerns the interaction between urge to smoke and external situation. "Sedative" smokers appear to experience their greatest need to smoke in situations characterized by low arousal; "stimulant" smokers in situations of high arousal. Members of each group were examined in two low arousal conditions. In one condition smoking was allowed, and in the other it was not. When allowed to smoke, it was shown that the two groups differed in their smoking behaviour: 10 stimulant but only 2 sedative smokers chose to do so. However, although smoking caused a significant increase in cardiac activity in smokers, no effects on subjective arousal were found. The implications of these findings are discussed.

Adult↗