The efficacy of cognitive behavioural therapy in somatoform disorders and medically unexplained physical symptoms: A meta-analysis of randomized controlled trials

Liu, Jing; Gill, Neeraj; Teodorczuk, Andrew; Li, Zhanjiang; Sun, Jing

doi:10.1016/j.jad.2018.10.114

Cited by 97 publications

(55 citation statements)

References 52 publications

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“…The prospective study by Kendler et al 23 showed that a high neuroticism level was associated with a high hazard ratio of the onset of major depressive episodes when stressful life events occurred. The meta-analysis by Liu et al 24 also showed that high neuroticism increases the risk of occurrence of depressive symptoms.…”

Section: Discussionmentioning

confidence: 97%

<p>Victimization In Childhood Affects Depression In Adulthood Via Neuroticism: A Path Analysis Study</p>

Tachi

Asamizu

Uchida

et al. 2019

NDT

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Background: Adverse experiences, such as low care, overprotection, or abuse in childhood increase the likelihood of depression via their effects on personality traits. Similarly, being victimized in childhood may affect the likelihood of depression via personality traits. In this case-control study, we hypothesized that being victimized in childhood is associated with depression in adulthood via its effect on neuroticism, and verified this hypothesis using path analysis. Subjects and methods: Eighty-two major depressive disorder (MDD) patients and 350 age-and-sex matched healthy controls completed self-administered questionnaires of demographic data, Patient Health Questionnaire-9, neuroticism, and victimization. The association between victimization, neuroticism, and depressive symptoms or having major depression was investigated by path analysis. Results: Multiple group path analysis, in which depressive symptoms were considered as dependent variables, showed that the direct effect of victimization in childhood on depressive symptoms was not statistically significant in either healthy controls or MDD patients (standardized path coefficient: 0.079 and 0.084, respectively), but their indirect effects via neuroticism were statistically significant (standardized path coefficient: 0.059 and 0.141, respectively). Path analysis, in which the distinction between healthy controls and MDD patients was a dependent variable, showed that both direct effects and indirect effects of victimization in childhood via neuroticism on the distinction between healthy controls and MDD patients were statistically significant (standardized path coefficient: 0.186 and 0.164, respectively). Limitations: Recall bias and the relatively small number of MDD patients are limitations of this study. Because it was a case-control survey, this study could not make any conclusions regarding causal associations. Conclusion: This study suggests the possibility of causal associations between victimization in childhood and depressive symptoms or MDD in adulthood, and the mediation of this association by neuroticism.

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Section: Discussionmentioning

confidence: 97%

<p>Victimization In Childhood Affects Depression In Adulthood Via Neuroticism: A Path Analysis Study</p>

Tachi

Asamizu

Uchida

et al. 2019

NDT

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“…The subgroups were the treatment form (individual vs. group); mode of delivery (face-to-face vs. remote); use of a diabetes-specific manual (yes vs. no); number of sessions (<10 vs. ≥10); duration of session (<90 min vs. ≥90min); type of DM (T1DM, T2DM, or both); drop-out rate (<20% vs. ≥20%); intervention type (CBT alone vs. CBT combined with other interventions); patients accompanied by mood symptoms (no vs. yes); and treatment used specific components of CBT (no vs. yes). The definition of using components for CBT was based on the Comprehensive Psychotherapeutic Intervention Rating Scale and previous studies (29)(30)(31). The following components of CBT were included in the subgroup analyses: cognitive strategy, behavioral experiment, mood management, stress management, homework assignment, and interpersonal strategies.…”

Section: Discussionmentioning

confidence: 99%

Effects of Cognitive Behavioral Therapy–Based Intervention on Improving Glycaemic, Psychological, and Physiological Outcomes in Adult Patients With Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials

Yang

Sun

2020

Front. Psychiatry

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Background: Patients with diabetes mellitus (DM) have a high risk of secondary physiological and psychological complications. Some interventions based on cognitive behavioral therapy (CBT) have been used to control glucose levels and improve negative emotions of patients with DM. This study was undertaken to provide an overview of the effectiveness of CBT-based interventions for improving glycaemic control, psychological, and physiological outcomes in adult patients with DM. Methods: Randomized controlled trials (RCTs) published in English and Chinese during 2007 and April 2019 were searched through various electronic databases including PubMed, Cochrane Library, Scopus, Embase, ProQuest Dissertations and Theses, and the Chinese databases (WanFang data and China National Knowledge Infrastructure). The primary outcome variables included glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), depression, and anxiety symptoms. The secondary outcomes were weight and cholesterol. Effect sizes were pooled by random-effects modelling using Comprehensive Meta-Analysis software. Physiotherapy Evidence Database tool was used to assess the quality of all included studies. Results: Twenty-three RCTs comprising 2,619 patients with DM (type 1 and type 2) were included in at least one meta-analysis. The results of the main analysis showed that CBTbased interventions had a better effect on reduced HbA1c (−0.275%, 95% CI: −0.443 to −0.107; p < 0.01) with Hedge's g of 0.466 (95% CI: 0.710-0.189), reduced depression symptoms with average reduction of −2.788 (95% CI: −4.450 to −1.207; p < 0.01) and Hedge's g of 0.966 (95% CI: 1.507-0.426). Twenty-three RCTs comprising 2,619 patients with DM (type 1 and type 2) were included in this meta-analysis. Several mediators of the effect were found through subgroup analysis for HbA1c and

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“…On the other hand, providing treatment of the accompanying psychological distress or mental disorders, tailored to the needs and treatment expectations of the patient. Treatment consisted of cognitive behavioral therapy (CBT) (Liu, Gill, Teodorczuk, Li, & Sun, ), acceptance and commitment therapy (ACT) (Barrett‐Naylor & Dawson, ; Cope & Agrawal, ), or problem‐solving treatment (PST) (Malouff, Thorsteinsson, & Schutte, ; Wilkinson & Mynors‐Wallis, ) provided by trained psychologists, in combination with pharmacotherapy provided by a physician or psychiatrist. The psychotherapeutic treatments were provided sequentially and were tailored to the needs and treatment expectations of the patients.…”

Section: Methodsmentioning

confidence: 99%

Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study

2020

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Objective Explore trauma, stress, and other predictive factors for treatment outcome in conversion disorder/functional neurological disorder (CD/FND). Methods Prospective observational design. Clinical cohort study among consecutive outpatients with DSM‐IV CD/FND in a specialized mental health institution for somatic symptom disorders and related disorders (SSRD), presented between 1 February 2010 and 31 December 2017. Patient files were assessed for early childhood trauma, childhood sexual abuse, current stress, and other predictive factors. Patient‐related routine outcome monitoring (PROM) data were evaluated for treatment outcome at physical (Patient Health Questionnaire [PHQ15], Physical Symptoms Questionnaire [PSQ]) level as primary outcome, and depression (Patient Health Questionnaire [PHQ9]), anxiety (General Anxiety Disorder [GAD7]), general functioning (Short Form 36 Health Survey [SF36]), and pain (Brief Pain Inventory [BPI]) as secondary outcome. Results A total of 64 outpatients were included in the study. 70.3% of the sample reported childhood trauma and 64.1% a recent life event. Mean scores of patients proceeding to treatment improved. Sexual abuse in childhood (F(1, 28) = 30.068, β = 0.608 p < .001) was significantly associated with worse physical (PHQ15, PSQ) treatment outcome. 42.2% reported comorbid depression, and this was significantly associated with worse concomitant depressive (PHQ9) (F[1, 39] = 11.526, β = 0.478, p = .002) and anxiety (GAD7) (F[1,34] = 7.950, β = 0.435, p = .008) outcome. Conclusion Childhood sexual abuse is significantly associated with poor treatment outcome in CD/FND. Randomized clinical trials evaluating treatment models addressing childhood sexual abuse in CD are needed.

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The efficacy of cognitive behavioural therapy in somatoform disorders and medically unexplained physical symptoms: A meta-analysis of randomized controlled trials

Cited by 97 publications

References 52 publications

<p>Victimization In Childhood Affects Depression In Adulthood Via Neuroticism: A Path Analysis Study</p>

<p>Victimization In Childhood Affects Depression In Adulthood Via Neuroticism: A Path Analysis Study</p>

Effects of Cognitive Behavioral Therapy–Based Intervention on Improving Glycaemic, Psychological, and Physiological Outcomes in Adult Patients With Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials

Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study

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