The results showed that all the participants, including those who received usual care, had improved in physical function after one year. But when those who had CBT were compared with those who hadn't, those who had been in talk therapy had significant physical improvements. Eleven percent of patients who had usual care improved in their physical function, as opposed to 11.7 percent of those who exercised, 18.4 percent for those who had CBT, and 18.5 percent for those receiving both CBT and exercise.
The results for mental measures were even more compelling. Highly significant improvements in fatigue, distress, mental health function and the ability to think and understand were seen with exercise alone, and with exercise plus CBT. Those who only had CBT showed improvement in mental health function and thinking/understanding.
Intriguingly, those participants with tenderness at multiple points on their bodies improved more than those who didn't -- and the higher the number of tender points, the more responsive to treatment they were. But other measures of pain did not respond to treatment. Veterans with disabilities, mood disorders and personality disorders did not improve as well as others.
While Gulf War veterans illnesses are not well-defined, or even accepted by many experts, Clauw stresses the importance of trying to address veterans' symptoms with effective therapies, no matter what the origin of the symptoms.
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
26-Oct-2002