Fatigue, Cortisol and ACT: A pre-post study on the effects of workrelated rehabilitation

Abstract

Objective: There is evidence that chronic stess leads to sustained levels of arousal, causing a dysregulation of the stress response. Patients with chronic fatigue often suffer from hypocortisolim. This study aimed to find to whether a 3.5 week long work-focused acceptance and commitment therapy (ACT) could change acute salivary cortisol response in patients with subjective chronic fatigue.

Methods: Participants (n=42) were consecutively recruited from the Hysnes outpatient clinic at St. Olavs Hospital, Trondheim. We used the Trier Social Stress Test for Groups to measure the effect of acute psychosocial stress in a laboratory setting before and after treatment of ACT. Saliva samples were used to measure neuroendocrine respnses to stress. 31 patients with fatigue (fatigue group) and 11 patients without fatigue  (non-fatigue group) were included in the study.

Results: The results showed no significant differences in cortisol output post treatment in the fatigue group or the non-fatigue group. A significant reduction of symptoms of anxiety, depression and fatigue was found in the fatigue group but not in the non-fatigue group.

Conclusion: ACT did not have a direct effect on cortisol output in this study. However the results imply that it lead to reduction of symptoms of patients with subjectively reported chronic fatigue.