Somatic Symptom Disorders

Journal Article Annotations
2016, 2nd Quarter

Somatic Symptom Disorders

Annotation by Anna Dickerman, MD
August 2016

  1. Brief multimodal psychosomatic therapy in patients with medically unexplained symptoms: Feasibility and treatment effects

PUBLICATION #1 — Somatic Symptom Disorders
Brief multimodal psychosomatic therapy in patients with medically unexplained symptoms: Feasibility and treatment effects
Wortman MS, Lucassen PL, van Ravesteijn HJ, et al
Fam Pract 2016; 33(4):346-353
Annotation

The finding: This randomized pilot study found that brief multimodal psychosomatic therapy (B.M.P.T.)—a multi-component treatment approach comprising elements of psychoeducation, relaxation training, mindfulness, and cognitive-behavioral therapy—is feasible and acceptable to patients with medically unexplained symptoms, and has the potential to result in symptom improvement.

Strengths and weaknesses: The strengths of this study include the fact that it is the first randomized pilot trial studying this modality of treatment for patients with medically unexplained symptoms. In terms of weaknesses, patients studied generally had mild to moderate symptom severity, which may affect the generalizability of the findings. The sample size was relatively small (42). The authors also note that there was difficulty in identifying and recruiting eligible patients, which could have introduced selection bias.

Relevance: Patients with medically unexplained symptoms can be problematic and costly in the health care system. While several treatments have been described for such patients, there is a need for further research examining forms of non-pharmacologic therapy. This paper suggests that B.M.P.T., a stepped-care and tailor-made approach which conforms well to expert treatment recommendations in the field, is acceptable and feasible with promising results for improving patients’ ability to cope with symptoms. The effectiveness of B.M.P.T. needs to be studied further in larger, more well-powered studies.