Self-Help for Medically Unexplained Symptoms: A Systematic Review and Meta-Analysis
Open accessAbstract
Objective: Medically unexplained symptoms (MUS), which are highly prevalent in all fields of medicine, are considered difficult to treat. The primary objective of this systematic review and meta-analysis was to assess the efficacy of self-help for adults with MUS. Methods: Four electronic databases were searched for relevant studies. Randomized controlled trials comparing self-help to usual care or waiting list in adults with MUS were selected. Studies were critically appraised using the Cochrane “risk of bias assessment tool.” Standardized mean differences (Hedges g) were pooled using a random-effects model. Outcomes were symptom severity and quality of life (QoL) directly posttreatment and at follow-up. Results: Of 582 studies identified, 18 studies met all inclusion criteria. Studies were heterogeneous with regard to patient populations, intervention characteristics, and outcome measures. Compared with usual care or waiting list, self-help was associated with lower symptom severity (17 studies, n = 1894, g = 0.58, 95% confidence interval = 0.32–0.84, p < .001) and higher QoL (16 studies, n = 1504, g = 0.66, 95% confidence interval = 0.34–0.99, p < .001) directly posttreatment. Similar effect sizes were found at follow-up. A high risk of bias was established in most of the included studies. However, sensitivity analyses suggested that this did not significantly influence study results. Funnel plot asymmetry indicated potential publication bias. Conclusions: Self-help is associated with a significant reduction in symptom severity and improvement of QoL. The methodological quality of included studies was suboptimal, and further research is needed to confirm the findings of this meta-analysis.
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- Authors
- van Gils, A., Schoevers, R. A., Bonvanie, I. J., Gelauff, J. M., Roest, A. M., & Rosmalen, J. G. M.
- Affiliations
- University Medical Center Groningen (NL)
- ORCID
- Venue
- Psychosomatic Medicine
- Published
- 2016-07
- Volume
- 78
- Issue
- 6
- Pages
- 728-739
- ISSN
- 0033-3174 (ISSN-L)
- 1534-7796
- OpenAlex
- W2480414246
- Cited by
- 55
- References
- 45
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 7 · 2022: 3 · 2021: 14 · 2020: 7 · 2019: 6 · 2018: 7 · 2016: 2
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- green
- research.rug.nl
- Licence
- other-oa
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- medically unexplained symptoms, self-help intervention, symptom severity, quality of life, usual care comparison, waitlist control, treatment efficacy, methodological quality, publication bias
- MeSH terms
- Medically Unexplained Symptoms, Adult, Female, Humans, Male, Middle Aged, Self Care
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