Cognitive-behavioural therapy for patients with multiple somatoform symptoms—a randomised controlled trial in tertiary care

Abstract 

Objective

(a) To evaluate the effect of a cognitive-behavioural inpatient treatment and (b) to analyse the differential efficacy of an additional (“soma”) group management training of somatisation.

Methods

The final sample consisted of 191 patients with somatisation syndrome (patients with at least eight DSM-IV somatoform symptoms). Patients were randomly assigned to (I) “standard treatment+soma” or (II) “standard treatment+relaxation training.” A waiting control group consisted of 34 patients. All patients were diagnosed with a structured clinical interview for DSM-IV and received an interview on medical consulting behaviour and questionnaires concerning somatoform symptoms, general psychopathology, subjective health status, and life satisfaction.

Results

Results show high impairment of the sample prior to treatment. At the 1-year follow-up, all outcome criteria were significantly reduced. The differential effect of the additional soma treatment was significant only for a reduction of visits to the doctor. Greatest longitudinal effect sizes were found for the reduction of somatoform symptoms.

Conclusion

Considering the subjects' high initial impairment, the outcome results are encouraging. The specific effect on health care use highlights the socioeconomic relevance.

Keywords:  Cognitive-behavioural therapy, Group therapy, Randomised controlled trial, Somatoform disorders, Somatisation, Somatisation syndrome, Tertiary care