Effects of Additional Individually Tailored Interventions on Sick-Leave and Symptoms in Patients with Exhaustion Disorder: A Randomized Controlled Trial.
Agneta Lindegård, Kristina Glise, Lilian Wiegner and 5 others
PMID 35801865WHAT IT FOUND
Adding tailored interventions like graded activity, sleep CBT, or memory training to standard care did not reduce sick leave or burnout symptoms more than standard care alone after 15 months.
Standard treatment appears effective on its own, suggesting extra individual therapies may not add further benefit.
Key findings
01There were no statistically significant differences between the intervention and control groups in sick-leave days or remaining symptoms of burnout at the 15-month follow-up.
02The control group received a comprehensive standard treatment including education, frequent appointments, and a stress-reduction group, which the authors suggest may be an effective standalone treatment.
03The intervention group received additional tailored components such as graded physical activity, CBT for insomnia, computerized memory training, or CBT for self-esteem based on baseline deficits.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The standard treatment itself was comprehensive and potentially effective, making it difficult to detect additional benefits from the tailored interventions. Patients had low energy and fatigue, which delayed their ability to start and engage with some interventions, particularly computerized training and CBT. Some patients were still attending interventions at the 15-month follow-up, which may have confounded the assessment of long-term effects. The study focused only on individual-level interventions and did not include workplace-directed components, which the authors suggest may be more critical for return-to-work outcomes. Dropout rates were low, but the analysis was intention-to-treat, and per-protocol analysis did not change the null results.
Declared interests
The authors declare no conflicts of interest. The study was conducted at the Institute of Stress Medicine in Gothenburg.
The easy way to misread this
Do not conclude that physical activity, sleep therapy, or cognitive training are ineffective for exhaustion disorder. This study tested adding these interventions to an already comprehensive standard care program. The null result may reflect that the standard care was sufficient, or that the timing and intensity of the added interventions were not optimal for this fatigued population, rather than that the components themselves have no value.