Cited by 478Psychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Cognitive-Behavioral Therapy for Somatization and Symptom Syndromes: A Critical Review of Controlled Clinical Trials

Kroenke, Kurt, Swindle, Ralph·2000·Psychotherapy and Psychosomatics

DOI 10.1159/000012395

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Abstract

OBJECTIVE: Few treatments for somatization have been proven effective. In the past decade, however, clinical trials of cognitive-behavioral therapy (CBT) have been promising. Our aim was to critically review and synthesize the evidence from these trials. METHODS: A search of the Medline database from 1966 through July 1999 was conducted to identify controlled trials designed to evaluate the efficacy of CBT in patients with somatization or symptom syndromes. RESULTS: A total of 31 controlled trials (29 randomized and 2 nonrandomized) were identified. Twenty-five studies targeted a specific syndrome (e.g. chronic fatigue, irritable bowel, pain) while 6 focused on more general somatization or hypochondriasis. Primary outcome assessment included physical symptoms, psychological distress and functional status in 28, 26 and 19 studies, respectively. Physical symptoms appeared the most responsive: CBT-treated patients improved more than control subjects in 71% of the studies and showed possibly greater improvement (i.e., a trend) in another 11% of the studies. A definite or possible advantage of CBT for reducing psychological distress was demonstrated in only 38 and 8% of studies, and for improving functional status in 47 and 26%. Group therapy and interventions as brief as 5 sessions proved efficacious. Benefits were sustained for up to 12 months. CONCLUSION: CBT can be an effective treatment for patients with somatization or symptom syndromes. Benefits can occur whether or not psychological distress is ameliorated. Since chronic symptoms are exceptionally common and most studies were conducted in referral populations, the optimal sequencing of CBT in treating primary care patients and the identification of those most likely to accept and respond to therapy should be further evaluated.

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Self-citation
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Self-citation

Authors: Kroenke, K., & Swindle, R.
Affiliations: Regenstrief Institute (US)
ORCID: Kroenke, Kurt
Swindle, Ralph
Venue: Psychotherapy and Psychosomatics
Publisher: S. Karger AG
Published: 2000
Volume: 69
Issue: 4
Pages: 205-215
ISSN: 0033-3190 (ISSN-L)
1423-0348
DOI: 10.1159/000012395
OpenAlex: W1977249692
Cited by: 478
References: 55
Citations by year: 2026: 1 · 2025: 5 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 3 · 2020: 3 · 2019: 12 · 2018: 16 · 2017: 18 · 2016: 9 · 2015: 16 · 2014: 14 · 2013: 20 · 2012: 25
FWCI: 15.15
Type: journal article
Language: en
Open access: closed
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)
Locations: Psychotherapy and Psychosomatics (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: cognitive behavioral therapy, somatization, health anxiety, chronic fatigue, irritable bowel syndrome, chronic pain, somatic symptoms, psychological distress, functional status, group therapy, treatment efficacy
MeSH terms: Humans, Psychophysiology, Somatoform Disorders, Syndrome, Cognitive Behavioral Therapy, Controlled Clinical Trials as Topic

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Cognitive-Behavioral Therapy for Somatization and Symptom Syndromes: A Critical Review of Controlled Clinical Trials

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