Cognitive-Behavioral Therapy for Somatization Disorder: A Randomized Controlled Trial
Abstract
BACKGROUND: Patients diagnosed as having somatization disorder (SD) who present with a lifetime history of multiple, medically unexplained physical symptoms represent a significant challenge to health care providers. To date, no psychotherapeutic or pharmacologic intervention has been found to produce clinically meaningful improvement in symptoms or functioning of patients with SD. We examined the efficacy of cognitive-behavioral therapy (CBT) for SD. METHODS: Eighty-four participants meeting criteria for SD were randomly assigned to 1 of 2 conditions: (1) standard medical care augmented by a psychiatric consultation intervention or (2) a 10-session, manualized, individually administered CBT regimen added to the psychiatric consultation intervention. Assessments were conducted at baseline and 3, 9, and 15 months after baseline. The primary outcome measure was the severity scale of the Clinical Global Impression Scale for Somatization Disorder (CGI-SD). Secondary outcome measures were responder status as determined by clinical ratings, self-reported measures of physical functioning and somatic symptoms, and health care utilization assessed via medical records. RESULTS: Fifteen months after baseline, somatization symptoms were significantly less severe in the group treated with CBT (0.84 points on the CGI-SD 7-point scale) (P<.001). Patients treated with CBT also were significantly more likely to be rated as either very much improved or much improved than patients treated with only augmented standard medical care (40% [n = 17] vs 5% [n = 2]). Cognitive-behavioral therapy was associated with greater improvements in self-reported functioning and somatic symptoms and a greater decrease in health care costs. CONCLUSION: For patients diagnosed as having SD, CBT may produce clinical benefits beyond those that result from the current state-of-the-art treatment.
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Individual CBT for somatisation disorder reduces overall service use.
“and reduced overall service use when offering individual CBT for somatisation disorder . 15”
From Cognitive behaviour therapy for long-term frequent attenders in primary care: A feasibility case series and treatment development study (2016) · cites this paper as [15]
Other studies demonstrate that service use can be reduced using CBT.
“This study sits among other studies demonstrating that service use can be reduced using CBT. 14-16”
From Cognitive behaviour therapy for long-term frequent attenders in primary care: A feasibility case series and treatment development study (2016) · cites this paper as [15]
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Rasmussen, N. H., Agerter, D. C., Colligan, R. C., Baird, M. A., Yunghans, C. E., & Cha, S. S. (2008) · PubMed Central · Cited by 12 · see citing works
Mangwana, S., Burlinson, S., & Creed, F. H. (2009) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.39.1.c · Cited by 13 · see citing works
Medically Unexplained Physical Symptoms: Why Counseling Psychologists Should Care About Them
McAndrew, L. M., Friedlander, M. L., Litke, D. R., Phillips, L. A., Kimber, J. M., & Helmer, D. A. (2019) · The Counseling Psychologist · doi:10.1177/0011000019888874 · Cited by 13 · see citing works
Psychotherapeutische Ansätze für Patienten mit somatoformen Störungen
Gottschalk, J.-M., & Rief, W. (2012) · Der Nervenarzt · doi:10.1007/s00115-011-3445-x · Cited by 13 · see citing works
Barr, W. (2014) · Springer eBooks · doi:10.1007/978-1-4939-0784-7_18 · Cited by 13 · see citing works
Lesley, A., & Robert, L. (2013) · InTech eBooks · doi:10.5772/52431 · Cited by 11 · see citing works
Cognitive behavioral therapy for PTSD and somatization: An open trial
Benítez, C. I. P., Zlotnick, C., Gomez, J., Rendón, M. J., & Swanson, A. C. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.02.005 · Cited by 12 · see citing works
Bartel, A., Jordan, J., Correll, D., Devane, A., & Samuelson, K. W. (2019) · Journal of Clinical Psychology · doi:10.1002/jclp.22855 · Cited by 9 · see citing works
A prevention programme for somatoform disorders is effective for affective disorders
García‐Campayo, J., Arévalo, E., Claraco, L. M., Alda, M., & del Hoyo, Y. L. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.031 · Cited by 11 · see citing works
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Functional Somatic Symptoms and Somatoform Disorders
Greenberg, D. B., Braun, I. M., & Cassem, N. H. (2008) · Elsevier eBooks · doi:10.1016/b978-0-323-04743-2.50026-3 · Cited by 11 · see citing works
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Duloxetine: A Review of its Safety and Efficacy in the Management of Fibromyalgia Syndrome
Smith, H. S., Bracken, D., & Smith, J. M. (2010) · Journal of Central Nervous System Disease · doi:10.4137/jcnsd.s4127 · Cited by 9 · see citing works
Kleinstäuber, M., Gottschalk, J.-M., Ruckmann, J., Probst, T., & Rief, W. (2018) · Cognitive Therapy and Research · doi:10.1007/s10608-018-9973-y · Cited by 9 · see citing works
- Authors
- Allen, L. A., Woolfolk, R. L., Escobar, J. I., Gara, M. A., & Hamer, R. M.
- Affiliations
- University of Medicine and Dentistry of New Jersey (US)
- Rutgers, The State University of New Jersey (US)
- ORCID
- Escobar, Javier I.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2006-07-24
- Volume
- 166
- Issue
- 14
- Pages
- 1512
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2095986335
- Cited by
- 209
- References
- 18
- Citations by year
- 2025: 7 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 5 · 2020: 6 · 2019: 12 · 2018: 5 · 2017: 8 · 2016: 12 · 2015: 8 · 2014: 16 · 2013: 14 · 2012: 21
- FWCI
- 9.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k08mh001662-03)
- National Institute of Mental Health (P20MH074634, K08 MH01662, R21MH066831)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- somatization disorder, cognitive behavioral therapy, medically unexplained symptoms, psychiatric consultation, treatment efficacy, health care utilization, health care costs, physical function
- MeSH terms
- Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Severity of Illness Index, Somatoform Disorders, Cognitive Behavioral Therapy, Treatment Outcome
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