Psychosocial treatments for employees with non-specific and persistent physical symptoms associated with indoor air: A randomised controlled trial with a one-year follow-up
Abstract
Objective Persistent physical symptoms (PPS) associated with indoor air without an adequate pathophysiological- or environmental-related explanation may lead to work disability and decreased health-related quality of life (HRQoL). We attempted to assess the effect of cognitive behavioural therapy (CBT) for PPS and also psychoeducation (PE) on these symptoms involving disability.Method The intention-to-treat (ITT) sample included 52 employees recruited from an occupational healthcare service randomised as either controls undergoing treatment as usual (TAU) or TAU enhanced with CBT or PE. The primary outcome was HRQoL measuring the severity of symptoms and restrictions in everyday life caused by them. Secondary outcomes included depressive, anxiety and insomnia symptoms, and intolerance to environmental factors, assessed at baseline and at 3-, 6- and 12-month follow-ups.Results At the 12-month follow-up assessment point, no statistically significant differences between treatments emerged following adjustment for gender, age, and HRQoL before the waiting period in the ITT analysis [F(2,46)=2.89, p=.07]. The secondary analysis revealed a significant improvement in HRQoL in the combined intervention group as compared with controls [F(1,47)=5.06, p=.03, g=0.41]. In total, 15% of participants dropped out during follow-up.Conclusions The results suggest that CBT for PPS or PE might not have a robust effect on HRQoL in PPS associated with indoor air, but the study did not achieve the planned power. Despite difficulties during the recruitment process, the final dropout rates remained low, and participants positively evaluated CBT, suggesting that it represents an acceptable treatment to them. Trial status This study was registered at the ClinicalTrials.gov registry (NCT02069002).
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Another Finnish study reported that although CBT or psychoeducation did not improve quality of life, the secondary analysis revealed a significant improvement in the combined intervention group compared to the control group.
“Another Finnish study reported that although CBT or psychoeducation did not improve quality of life, the secondary analysis revealed a significant improvement in the combined intervention group compared to the control group [29].”
The significant impact observed on work ability among individuals with IE-related PPS is noteworthy, given the limited and mixed results of previous psychosocial treatments of this condition.
“In addition, the significant impact observed on work ability among individuals with IE-related PPS is noteworthy, given the limited and mixed results of previous psychosocial treatments of this condition [22, 28, 29].”
While some studies have reported positive effects on illness perceptions, coping strategies, and sleep quality in individuals with environmental intolerance, clear improvements in symptoms, quality of life or work ability have generally not been observed, except in one study.
“While some studies have reported positive effects on illness perceptions [30], coping strategies, and sleep quality in individuals with environmental intolerance [31], clear improvements in symptoms, quality of life [29, 30] or work ability [28] have generally not been observed, except in one study [32].”
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- Authors
- Selinheimo, S., Vuokko, A., Hublin, C., Järnefelt, H., Karvala, K., Sainio, M., Suojalehto, H., & Paunio, T.
- Affiliations
- University of Helsinki (FI)
- Finnish Institute of Occupational Health (FI)
- Corresponding author
- Selinheimo, Sanna
- ORCID
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2020-04
- Volume
- 131
- Pages
- 109962
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W3006441758
- Cited by
- 9
- References
- 65
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2021: 1 · 2020: 2
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- WOS
- Funders
- Finnish Work Environment Fund (113076, ref 113076)
- Social Insurance Institution of Finland (23/26/2014)
- Signe and Ane Gyllenberg Foundation
- Varma Mutual Pension Insurance Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- persistent physical symptoms, non-specific symptoms, indoor air, psychosocial interventions, cognitive behavioral therapy, psychoeducation, health-related quality of life, work disability, occupational health, depressive symptoms, anxiety symptoms, insomnia, workers
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