A [RCT] Evaluating Integrative Psychotherapeutic Group Treatment Compared to Self-Help Groups in Functional Vertigo/Dizziness, 2021, Limburg et al

[MSEsperanza]

Limburg K, Radziej K, Sattel H, Henningsen P, Dieterich M, Probst T, Dale R, Lahmann C.

A Randomized Controlled Trial Evaluating Integrative Psychotherapeutic Group Treatment Compared to Self-Help Groups in Functional Vertigo/Dizziness.

J Clin Med. 2021 May 20;10(10):2215. doi: 10.3390/jcm10102215. PMID: 34065517; PMCID: PMC8161006.


Abstract

We tested the efficacy of an integrative psychotherapeutic group treatment (IPGT) in reducing vertigo/dizziness-related impairment along with depression, anxiety, and somatization by conducting a randomized controlled superiority trial comparing IPGT to self-help groups moderated by a clinical psychologist (SHG).

Adult patients with functional vertigo and dizziness symptoms were randomly allocated to either the IPGT or SHG as active control group. Outcomes were assessed at baseline (t0), after treatment lasting 16 weeks (t1), and 12 months after treatment (t2). A total of 81 patients were assigned to IPGT and 78 patients were assigned to SHG.

Vertigo-related impairment was reduced in both conditions (IPGT: t0-t1: d = 1.10, t0-t2: d = 1.06; SHG: t0-t1: d = 0.86, t0-t2: d = 1.29), showing the efficiency of both IPGT and SHG.

Clinically relevant improvements were also obtained for depression in both groups.

Linear mixed model analyses revealed no differences between groups for all outcomes (effect of group for the primary outcome: b = -1.15, SE = 2.13, t = -0.54, p = 0.59).

Attrition rates were higher in SHG (52.6%) than in IPGT (28.4%).

Both conditions improved primary and secondary outcomes while IPGT was better accepted by patients than SHG.

Trial registration: ClinicalTrials.gov, Identifier: NCT02320851.

 

[MSEsperanza]

One of the study's authors is Peter Henningsen who has a thread of his own here:

Full article translation excepting references reproduced below - Fair use, given the context: https://www-dgpm-de.translate.goog/...omatik/?_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=en

German Society for Psychosomatic Medicine and Medical Psychotherapy (DGPM) registered association

Long Covid - where is the psychosomatics?
Created by Peter Henningsen, Munich |11/04/2022 | news

"The debate about what causes the sometimes pronounced symptoms that people suffer from after they have been infected with Covid-19 and which are referred to by terms such as Long and Post Covid is fierce.

Very many of those affected, self-help groups and also physicians represent vehemently one-sided biological conceptions of the cause, combined with sometimes downright scornful rejection of psychosomatic aspects of this symptom syndrome.

There are parallels to the debate about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), it is also said that many patients with Long Covid also suffer from ME/CFS. Unfortunately, these voices also attract a great deal of media attention, being propagated by Ev Hirschhausen, for example. The whole thing is not a specifically German phenomenon,

As psychosomatic physicians, it is clear to us that in the experience of persistently stressful physical complaints, such as in the case of Long Covid Syndrome, in addition to possible, possibly yet undiscovered biological, e.g Factors, up to current and biographical stressors. In this biopsychosocial understanding, Long Covid can be seen as a functional somatic syndrome.

However, we also know that with our outdated models for the purely psychogenic cause of such physical complaints, we have historically offered a lot of scope for attack for the simply wrong equation of psychosomatic and psychogenic that is often used polemically in today's debate.

But what do we do to not only internally contradict the abridged and falsified, sometimes slandering, anti-psychosomatic statements, but also to oppose something (professionally) publicly? There are different levels here: on the one hand, psychosomatics represent our view of Long Covid in nationwide interdisciplinary research projects and associations, a large multi-centre joint project on Long Covid (PsyLoCo, spokeswoman Dr. C. Allwang, Munich) is coordinated by Psychosomatics .

Groups in Essen and Hamburg have already published interdisciplinary studies with psychosomatic leadership or participation (Fleischer et al. 2022, Engelmann et al. 2022), which show the importance of psychosocial factors for the risk of contracting Long Covid or for the clinical picture itself.

In a large article in the Süddeutsche Zeitung on Long Covid at the beginning of September, psychosomatic experts and perspectives were presented so clearly that the author was exposed to a considerable shitstorm from supporters of purely biological perspectives (Bartens 2022). Members of the Bundestag Health Committee were also contacted and provided with material on the issues.

Since the strongly anti-psychosomatic and also anti-psychotherapeutic attitudes are traditionally particularly pronounced in the group of ME/CFS advocates, it is important that psychosomatics show the flag here as well.

The AWMF-S3 guideline of the German Society for General Medicine on fatigue was so strongly influenced by various patient self-help groups and medical advocates of the biological ME/CFS concept that there, for example, psychotherapy and stepped activation as a form of treatment are actively discouraged in the presence of ME/CFS became.

On the initiative of the DGPM and DKPM, a dissenting opinion was written, which was also supported by the DGPPN and the DGIM (internal medicine), which contradicts these views and is included in the guideline.

Members of the DGPM are also co-authors on an international publication with more than 50 co-authors that exposed serious methodological errors in the guideline on ME/CFS published by the English guideline organization NICE last year and to which many advocates of the biological views refer will.

The DGPM and DKPM also comment on a preliminary report by IQWiG on ME/CFS, which is based heavily on the NICE guidelines, but fortunately draws its own conclusions that are somewhat more favorable for psychotherapy and graded activation, with the aim that in the assessment there the benefit of psychotherapy is emphasized even more clearly. which the English guideline organization NICE published last year and to which many advocates of biological views refer.

The DGPM and DKPM also comment on a preliminary report by IQWiG on ME/CFS, which is based heavily on the NICE guidelines, but fortunately draws its own conclusions that are somewhat more favorable for psychotherapy and graded activation, with the aim that in the assessment there the benefit of psychotherapy is emphasized even more clearly. which the English guideline organization NICE published last year and to which many advocates of biological views refer.

The DGPM and DKPM also comment on a preliminary report by IQWiG on ME/CFS, which is based heavily on the NICE guidelines, but fortunately draws its own conclusions that are somewhat more favorable for psychotherapy and graded activation, with the aim that in the assessment there the benefit of psychotherapy is emphasized even more clearly.

Even more activity would certainly be desirable, but it comes up against the limits of time and human resources. After all, we wanted to show that psychosomatic medicine raises its voice in various places - and we want to encourage you, dear colleague, to do the same in your environment whenever the opportunity arises. We owe this to our profession, but above all to the patients affected."

Members of the DGPM are also co-authors on an international publication with more than 50 co-authors that exposed serious methodological errors in the guideline on ME/CFS published by the English guideline organization NICE last year and to which many advocates of the biological views refer

The DGPM and DKPM also comment on a preliminary report by IQWiG on ME/CFS, which is based heavily on the NICE guidelines, but fortunately draws its own conclusions that are somewhat more favorable for psychotherapy and graded activation, with the aim that in the assessment there the benefit of psychotherapy is emphasized even more clearly.

 

[rvallee]

Vertigo-related impairment was reduced in both conditions (IPGT: t0-t1: d = 1.10, t0-t2: d = 1.06; SHG: t0-t1: d = 0.86, t0-t2: d = 1.29), showing the efficiency of both IPGT and SHG.

Whew lad, this is not how this works at all. Especially when

Attrition rates were higher in SHG (52.6%) than in IPGT (28.4%).

Especially you have garbage methodology and fully generic hand-waving "treatment" with zero details anyway.

This entire era of medicine should be labeled as the era of confirmation bias. Completely unserious.

 

[cassava7]