Cognitive Behavioral Therapy Versus Progressive Muscle Relaxation Training for Multiple Somatoform Symptoms: Results of a Randomized Controlled Trial

Abstract

Although unexplained multiple symptoms and somatoform disorders are a highly prevalent condition in primary practice, few randomized controlled trials of cognitive behavioral therapy (CBT) have been conducted. Moreover, most of these trials have used only the usual medical treatment or wait list control groups. The present study included 134 outpatients showing at least two medically unexplained symptoms. They were randomly assigned to eight weekly group sessions of either CBT or progressive muscle relaxation (PMR) or wait list control and were assessed before and after treatment as well as 6 months after the end of treatment. The number and intensity of somatoform symptoms were the primary outcome measures; depression, anxiety and physical and mental health constituted the secondary outcome measures. CBT showed small effects (Cohen’s d = 0.44) for the treatment of somatoform disorders. Benefits of the treatment were sustained over 6 months of follow-up. However, no differential effects of CBT and PMR were found. In conclusion, both CBT and PMR appear to be effective treatments for multiple somatoform symptoms.