Presentation Information
[P-26-03]Adapting Cognitive Behavior Therapy for Long COVID Neuropsychiatric Symptoms: Development and Feasibility of a Hybrid In-Person and Self-Help Program
*Naoki Takamatsu, Toshitaka Hamamura, Kazufumi Yoshida, Hironori Kuga (National Center of Neurology and Psychiatry(Japan))
Keywords:
long COVID,cognitive behavior therapy,neuropsychiatric symptoms,hybrid intervention,post-exertional malaise
Background: Long COVID affects 10-20% of COVID-19 survivors, with persistent symptoms including fatigue, cognitive impairment, depression, and anxiety continuing for years after infection. A 3-year follow-up study revealed significant neurological and mental health sequelae contributing substantially to disability-adjusted life years. Drawing on similarities between long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), particularly regarding post-exertional malaise, we aimed to develop and evaluate a cognitive behavior therapy (CBT) program addressing implementation feasibility.
Methods: Following literature reviews and a mixed-methods assessment of Japanese long COVID patients (n=46), we developed an 8-session hybrid CBT program combining 3 in-person sessions and 5 self-help modules. The program incorporated energy management, cognitive restructuring, behavioral activation with pacing considerations, and mindfulness techniques. Our feasibility study (n=12-15) evaluates primary outcomes of treatment completion/dropout rates and adverse events, with secondary outcomes including quality of life (SF-36), fatigue (CIS), self-efficacy (GSES), and program satisfaction over 20-weeks. The protocol was designed to align with national healthcare implementation frameworks and received ethics committee approval.
Results: Our literature review identified substantial overlap between long COVID and ME/CFS, with shared immune dysregulation, neuroinflammation, and metabolic dysfunction, while finding distinct disease trajectories. Evidence suggests ME/CFS may represent a severe phenotype in a subset of long COVID patients. Management principles applicable to both conditions include patient validation, comprehensive needs assessment, individualized energy management, and careful monitoring for post-exertional malaise. Our mixed-methods study revealed that patients preferred hybrid or in-person delivery formats, with optimal session durations of 30-60 minutes and 8-12 sessions total. The protocol integrates these findings to balance implementation feasibility within healthcare frameworks.
Conclusion: This study introduces a patient-informed CBT protocol tailored for long COVID neuropsychiatric symptoms that balances clinical needs with implementation constraints. Preliminary intervention cases will be presented at the conference. The feasibility evaluation will provide insights for refinement and larger effectiveness trials.
Methods: Following literature reviews and a mixed-methods assessment of Japanese long COVID patients (n=46), we developed an 8-session hybrid CBT program combining 3 in-person sessions and 5 self-help modules. The program incorporated energy management, cognitive restructuring, behavioral activation with pacing considerations, and mindfulness techniques. Our feasibility study (n=12-15) evaluates primary outcomes of treatment completion/dropout rates and adverse events, with secondary outcomes including quality of life (SF-36), fatigue (CIS), self-efficacy (GSES), and program satisfaction over 20-weeks. The protocol was designed to align with national healthcare implementation frameworks and received ethics committee approval.
Results: Our literature review identified substantial overlap between long COVID and ME/CFS, with shared immune dysregulation, neuroinflammation, and metabolic dysfunction, while finding distinct disease trajectories. Evidence suggests ME/CFS may represent a severe phenotype in a subset of long COVID patients. Management principles applicable to both conditions include patient validation, comprehensive needs assessment, individualized energy management, and careful monitoring for post-exertional malaise. Our mixed-methods study revealed that patients preferred hybrid or in-person delivery formats, with optimal session durations of 30-60 minutes and 8-12 sessions total. The protocol integrates these findings to balance implementation feasibility within healthcare frameworks.
Conclusion: This study introduces a patient-informed CBT protocol tailored for long COVID neuropsychiatric symptoms that balances clinical needs with implementation constraints. Preliminary intervention cases will be presented at the conference. The feasibility evaluation will provide insights for refinement and larger effectiveness trials.