Abstract
BackgroundRecurrent and impairing functional somatic syndromes (FSS) are common in adolescents. Despite a high need for care, empirically supported treatments are lacking for youth. The aim of this uncontrolled pilot study was to assess feasibility and treatment potential of a new intervention with group-based Acceptance and Commitment Therapy (ACT) in a generic treatment approach for adolescents with multiple FSS.MethodsTwenty-one patients received ‘ACT for Health in Adolescents’ (AHEAD) (30 h), specifically developed for adolescents (aged 15–19 years) with moderate to severe FSS. Close relatives attended an information meeting to facilitate support of the patients throughout treatment. Treatment satisfaction was evaluated by means of self-report and relatives’ impressions. Self-reported physical health at 3 months follow-up (FU) after end of treatment was the primary outcome whereas secondary outcomes included symptom burden, limitation due to symptoms, illness worry, emotional distress and physical and emotional symptoms. Treatment targets were assessed by measures on illness behaviour, illness perception and psychological inflexibility.ResultsNineteen patients (90.5%) completed the treatment with a high overall attendance rate of 93%. All would recommend the treatment to a friend with similar problems. Close relatives rated it valuable to participate in an information meeting. Patients’ physical health improved significantly from assessment to FU with a clinically relevant mean change of 8.9 points (95% CI [5.4; 12.4]; SRM 0.91 [0.26;1.57]). Improvement was also seen on all secondary outcome measures, from assessment to FU. Maladaptive illness behaviours and perceptions as well as psychological inflexibility showed a significant decline from assessment to FU.ConclusionAHEAD was feasible and potentially efficacious and warrants testing in a larger clinical trial.Trial registrationClinical Trials gov NCT04464447, registration date July 9th, 2020. Retrospectively registered.
Highlights
Recurrent and impairing functional somatic syndromes (FSS) are common in adolescents
As part of the feasibility evaluation, we examined the utility of different questionnaires to assess the defined treatment targets as well as the overall respondent burden
Patient characteristics A total of 54 consecutively referred adolescents were screened for eligibility; 16 did not fulfil study criteria, 6 were referred from another region and 1 did not consent to referral (Fig. 2)
Summary
Recurrent and impairing functional somatic syndromes (FSS) are common in adolescents. Despite a high need for care, empirically supported treatments are lacking for youth. The aim of this uncontrolled pilot study was to assess feasibility and treatment potential of a new intervention with group-based Acceptance and Commitment Therapy (ACT) in a generic treatment approach for adolescents with multiple FSS. While the symptoms are self-limiting in most cases, approximately 5–10% report persistent symptoms, and may receive diagnoses of functional somatic syndromes (FSS) [2]. Symptoms sustain into adulthood, carrying a significant risk of long-term impairment, reduced probability of obtaining a higher education and a high use of health care costs [9,10,11,12,13]. Parental overprotective behaviour can increase distress and disability in the young [18,19,20,21], and better outcome is suggested when parents support a shift for more accommodative coping styles [22, 23]
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