Using clinical patient characteristics to predict treatment outcome of cognitive behavior therapies for individuals with medically unexplained symptoms: A systematic review and meta-analysis

Sarter, Lena; Heider, Jens; Witthöft, Michael; Rief, Winfried; Kleinstäuber, Maria

doi:10.1016/j.genhosppsych.2022.03.001

Cited by 9 publications

(5 citation statements)

References 61 publications

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“…A recent meta-analysis on short-term psychodynamic (outpatient) psychotherapy reported a mean effect size for the reduction of somatic symptoms of d = 0.84 ( 36 ), another meta-analysis on psychological interventions for patients with medically unexplained symptoms reported a mean effect size of d = 0.6 ( 37 ). The fact that higher symptom severity predicts somewhat smaller positive effects has been reported in a recent meta-analysis ( 38 ). A general overview of the efficacy of different treatment approaches is given by Henningsen et al ( 39 ).…”

Section: Discussionsupporting

confidence: 58%

The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany

et al. 2023

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BackgroundReliable outcome data of psychosomatic inpatient and day hospital treatment with a focus on psychotherapy are important to strengthen ecological validity by assessing the reality of mental health care in the field. This study aims to evaluate the effectiveness of inpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy in a prospective, naturalistic, multicenter design including structured assessments.MethodsStructured interviews were used to diagnose mental disorders according to ICD-10 and DSM-IV at baseline. Depression, anxiety, somatization, eating disorder and posttraumatic stress disorder (PTSD) symptoms, as well as personality functioning were assessed by means of questionnaires on admission and at discharge.Results2,094 patients recruited by 19 participating university hospitals consented to participation in the study. Effect sizes for each of the outcome criteria were calculated for 4–5 sub-groups per outcome domain with differing severity at baseline. Pre-post effect sizes for patients with moderate and high symptom severity at baseline ranged from d = 0.78 to d = 3.61 with symptoms of PTSD, depression, and anxiety showing the largest and somatization as well as personality functioning showing somewhat smaller effects.ConclusionsInpatient and day hospital treatment in German university departments of Psychosomatic Medicine and Psychotherapy is effective under field conditions.Clinical trial registrationhttps://drks.de/search/de/trial/DRKS00016412, identifier: DRKS00016412.

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Section: Discussionsupporting

confidence: 58%

The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany

et al. 2023

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“…When patients present with medically unexplained symptoms, the aetiology is most often not monocausal but rather multifactorial, and can be better understood through the biopsychosocial model which takes into account the complex interplay of biological, psychological and social factors 1 . However, symptoms are frequently attributed monocausally to an abnormal occlusion, faulty dentures or temporomandibular joint findings 2 .…”

Section: Unambiguous Usagea Of ‘Functional’mentioning

confidence: 99%

A functional problem—on a linguistic ambiguity in dentistry

Herpel

Schwindling

Rammelsberg

et al. 2023

J of Oral Rehabilitation

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When patients present with medically unexplained symptoms, the aetiology is most often not monocausal but rather multifactorial, and can be better understood through the biopsychosocial model which takes into account the complex interplay of biological, psychological and social factors. 1 However, symptoms are frequently attributed monocausally to an abnormal occlusion, faulty dentures or temporomandibular joint findings. 2 Curiously, a linguistic obstacle may contribute to this understanding (or misunderstanding): the ambiguity of the word FUNCTIONAL.The ambiguity of words is common in everyday language.Examples are the words bright, bank, wing, run-they are called polysemes. In many cases, there are between the different uses of a word. 3 An example of this is the polysemous adjective hard:Hard-hearted, Hard life, Hard material, Hard water.The first two expressions show a certain affinity with the third expression (hard material). They can be described as metaphorical transfers. In the fourth example (hard water), on the contrary, there is no clear connection with the other usages. 'Such expressions presuppose knowledge of technical language for their interpretation or must be regarded as conventionalized in technical language'. 4 It should therefore be noted that the use of polysemous adjectives in technical language, as in medical language, is generally not intuitively comprehensible; their meaning must be learned.In dentistry, there are at least three independent uses of the term functional, one of which is rather neutral and the other two of which have specific, sometimes conflicting, meanings. We argue that this ambiguous, undifferentiated usage can potentially contribute to diagnostic misunderstandings and treatment failures. The first of the two conflicting uses is found in expressions such as:

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“…Mais de nombreux mécanismes psychologiques potentiels du COVID long constituant eux-mêmes des facteurs modifiables, leur pertinence en tant que cibles thérapeutiques pourrait d'ores et déjà être testée par des essais thérapeutiques ayant recours à des traitements déjà validés. Outre le traitement d’un trouble anxieux ou dépressif comorbide, pouvant être associée à de nombreux symptômes attribués à l’affection post-COVID-19 tels qu’une intense fatigue, des douleurs, des troubles cognitifs ou encore un fonctionnement altéré du système nerveux autonome [34] , [40] , des interventions thérapeutiques dans le COVID long pourraient s’inspirer de celles utilisées dans le traitement des « troubles somatiques fonctionnels » [41] , [42] , [43] . De fait, l’affection post-COVID-19 partage de nombreuses caractéristiques avec les troubles somatiques fonctionnels [44] , [45] , [46] .…”

Section: Mécanismes Psychologiques Et Cibles Thérapeutiques Dans L’af...unclassified

“…La prise en compte de ces facteurs dans le traitement de l’affection post-COVID-19 pourrait contribuer à une autonomisation ( empowerment ) du patient en le considérant comme un acteur incontournable de sa guérison [5] . En effet, les interventions ayant fait la preuve de leur efficacité dans les troubles somatiques fonctionnels sont majoritairement non médicamenteuses et nécessitent une participation active du patient, comme les thérapies cognitives et comportementales [42] , [43] ou la reprise progressive d’une activité physique adaptée [48] .…”

Section: Mécanismes Psychologiques Et Cibles Thérapeutiques Dans L’af...unclassified

Rôle des facteurs psychologiques dans l’affection post-COVID-19

Lemogne

Ranque

2023

Bulletin de l'Académie Nationale de Médecine

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Using clinical patient characteristics to predict treatment outcome of cognitive behavior therapies for individuals with medically unexplained symptoms: A systematic review and meta-analysis

Cited by 9 publications

References 61 publications

The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany

The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany

A functional problem—on a linguistic ambiguity in dentistry

Rôle des facteurs psychologiques dans l’affection post-COVID-19

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