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Cited by 113Psychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Effectiveness of a Time-Limited Cognitive Behavior Therapy Type Intervention Among Primary Care Patients With Medically Unexplained Symptoms

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Escobar, J. I., Gara, M. A., Diaz-Martinez, A. M., Interian, A., Warman, M., Allen, L. A., Woolfolk, R. L., Jahn, E. +1 more·2007·The Annals of Family Medicine
DOI 10.1370/afm.702PMC PMC1934981
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Abstract

PURPOSE: Patients seeking care for medically unexplained physical symptoms pose a major challenge at primary care sites, and there are very few well-accepted and properly evaluated interventions to manage such patients. METHODS: We tested the effectiveness of a cognitive behavior therapy (CBT)-type intervention delivered in primary care for patients with medically unexplained physical symptoms. Patients were randomly assigned to receive either the intervention plus a consultation letter or usual clinical care plus a consultation letter. Physical and psychiatric symptoms were assessed at baseline, at the end of treatment, and at a 6-month follow-up. All treatments and assessments took place at the same primary care clinic where patients sought care. RESULTS: A significantly greater proportion of patients in the intervention group had physical symptoms rated by clinicians as "very much improved" or "much improved" compared with those in the usual care group (60% vs 25.8%; odds ratio = 4.1; 95% confidence interval, 1.9-8.8; P<.001). The intervention's effect on unexplained physical symptoms was greatest at treatment completion, led to relief of symptoms in more than one-half of the patients, and persisted months after the intervention, although its effectiveness gradually diminished. The intervention also led to significant improvements in patient-reported levels of physical symptoms, patient-rated severity of physical symptoms, and clinician-rated depression, but these effects were no longer noticeable at follow-up. CONCLUSIONS: This time-limited, CBT-type intervention significantly ameliorated unexplained physical complaints of patients seen in primary care and offers an alternative for managing these common and problematic complaints in primary care settings.

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  • Like other interventions for people with frequent attendance, improvements in mental health outcomes occurred after treatment but were not sustained at 12 months.

    “Like other interventions for people with frequent attendance, improvements in mental health outcomes occurred after treatment but were not sustained at 12 months. 11”

    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 [11]

    The Mixed Model Analyses report a significant improvement in depressive symptoms at the end of treatment, but no significant difference at the six-month follow-up. The Data Analyses section confirms that the study assessed a six-month follow-up, not a 12-month outcome. The participants were primary care patients with medically unexplained symptoms; the cited passages do not establish that they were selected for frequent attendance. (LLM, conf=0.90)

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Authors
Escobar, J. I., Gara, M. A., Diaz-Martinez, A. M., Interian, A., Warman, M., Allen, L. A., Woolfolk, R. L., Jahn, E., & Rodgers, D.
Affiliations
Rutgers, The State University of New Jersey (US)
ORCID
Venue
The Annals of Family Medicine
Publisher
Annals of Family Medicine
Published
2007-07-01
Volume
5
Issue
4
Pages
328-335
ISSN
  • 1544-1709 (ISSN-L)
  • 1544-1717
DOI
10.1370/afm.702
PMC
PMC1934981
OpenAlex
W2128309331
Cited by
113
References
37
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2022: 1 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 6 · 2016: 8 · 2015: 8 · 2014: 10 · 2013: 13 · 2012: 14
FWCI
5.05
Type
journal article
Language
en
Open access
Locations
  • The Annals of Family Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r21mh052584-03)
  • National Institute of Mental Health (1P20MH74634-01, P20MH074634, 1R01MH 60262-01, R21 MH52584)
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
medically unexplained symptoms, cognitive behavioral therapy, time-limited intervention, primary care, somatic symptoms, depression, symptom severity, treatment effectiveness
MeSH terms
Academic Medical Centers, Adolescent, Adult, Aged, Ambulatory Care Facilities, Anxiety, Depression, Family Practice, Female, Humans, Interview, Psychological, Male, Mental Health Services, Middle Aged, New Jersey, Primary Health Care, Psychotherapy, Brief, Referral and Consultation, Severity of Illness Index, Somatoform Disorders, Cognitive Behavioral Therapy, Treatment Outcome, Urban Health Services

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