Group body psychotherapy for the treatment of somatoform disorder - a partly randomised-controlled feasibility pilot study

Frank Röhricht,Heribert Sattel,Claas Lahmann,Christian Kuhn

doi:10.1186/s12888-019-2095-6

Abstract

BackgroundClinical outcomes for patients with heterogeneous somatoform disorder (bodily distress disorder, including medically unexplained symptoms) are suboptimal, new treatments are required to improve acceptance. Body-oriented psychological therapy approaches have been identified as potentially beneficial additions to the portfolio of treatments. This study was aiming to assess the acceptability, the potential benefits, and associated change processes of manualised group body psychotherapy (BPT) for outpatients with Somatoform Disorder.MethodsA randomized controlled feasibility trial was carried out with follow-up at 6 months after baseline assessments using the Primary Health Questionnaire (PHQ), Somatic Symptom Screening Scale (SOMS-7), quality of life ratings (Short-Form Health Survey-36; SF-36) and body image measures (Dresden Body Image Questionnaire). Acceptance was assessed with the Helping Alliance Scale (HAS).ResultsA total of 24 patients were recruited to participate. Sixteen patients were randomly assigned to receive either manualised BPT or TAU, eight patients were directly assigned to BPT. Drop-out rates were acceptable, patients reported to be highly satisfied with the group intervention. Somatic symptom levels reduced significantly in the BPT group. Additionally, a significant effect on self-acceptance and the mental component of quality of life was observed.ConclusionGroup body psychotherapy is a feasible and acceptable treatment for patients with somatoform disorder and a larger trial studying the effectiveness of BPT in these patients should be conducted.Trial registrationRetrospectively registered SRCTN12277345; Trial Registraton Date: 27/03/2019.

Highlights

Clinical outcomes for patients with heterogeneous somatoform disorder are suboptimal, new treatments are required to improve acceptance
There is a paucity of research addressing the effects of psychological intervention for unspecific somatoform disorder and a Cochrane systematic review of non-pharmacological treatments for somatoform disorders and medically unexplained symptoms concluded that the effect sizes in trials have been low and that “compared with enhanced or structured care, psychological therapies generally were not more effective for most of the outcomes” [10, page 2]
According to this Cochrane review, Cognitive Behaviour Therapy (CBT) was more effective than usual care in reducing the severity of medically unexplained physical symptoms; three CBT studies demonstrated an impact on dysfunctional cognitions, emotions or behaviours, the authors reccomended a particular focus on high-quality studies of physical therapies [10]

Summary

Introduction

Clinical outcomes for patients with heterogeneous somatoform disorder (bodily distress disorder, including medically unexplained symptoms) are suboptimal, new treatments are required to improve acceptance. In previous studies specific psychosomatic disorders such as tension headache, IBS, Asthma and in one study somatoform disorders in a group of inpatients were successfully treated with a symptom-focused approach of body-oriented psychological therapy (BOPT) [13,14,15,16,17]. The rational for this approach is based upon efforts to enrich, widen and complete patient’s explanatory beliefs by steering them towards the direction of a more inclusive bio-psycho-social model whilst exploring new ways of relating to the somatic symptoms in order to alleviate distress. From a patient perspective it can be hypothesised that a body-oriented intervention is better accepted than “talking therapy”

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