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Internet-based emotional awareness and expression therapy for somatic symptom disorder: A randomized controlled trial 2022 Maroti et al

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Nov 4, 2022.

  1. Andy

    Andy Committee Member

    Messages:
    22,309
    Location:
    Hampshire, UK
    Highlights

    • I-EAET reduces somatic symptoms at post-treatment and 4-month follow-up more than control.
    • There were 7 times more responders in I-EAET (21%) than control (3%) at follow-up.
    • I-EAET is a promising treatment for Somatic Symptom Disorder.

    Abstract

    Objective
    Somatic symptom disorder (SSD) is commonly encountered in health care settings. Cognitive-behavioural treatments have been most extensively studied, but they tend to have small effects of temporary duration. Emotional awareness and expression therapy (EAET) is a newly developed treatment for SSD, targeting emotional processing of trauma and conflict as a mechanism of symptom change. In an earlier uncontrolled study of self-guided, internet-administrated EAET (I-EAET), we found substantial reductions in somatic symptoms, prompting the need for a randomized controlled trial of I-EAET.

    Methods
    We conducted a 2-arm RCT, comparing 10-week I-EAET (n = 37) to a waitlist control (WL; n = 37). Primary outcomes were reductions of somatic symptoms (PHQ-15) and pain intensity (BPI-4) at post-treatment, with a 4-month evaluation of effect duration. We also analysed emotional processing (EPS-25) and depression (PHQ-9) as possible mediators of I-EAET's effects.

    Results
    Compared to controls, I-EAET significantly reduced somatic symptoms at both post-treatment and follow-up. I-EAET also reduced pain, depression, insomnia, and anxiety at post-treatment, but these effects were not retained at follow-up. As hypothesized, a facet of emotional processing partially mediated the treatment effect on somatic symptoms, even when controlling for depression.

    Conclusions
    Although treatment effects were smaller than in the previous uncontrolled trial, I-EAET is a promising treatment for SSD, with a minority of patients (around 20%) experiencing substantial clinical improvement. The benefits of I-EAET are partially mediated by improved emotional processing. Future research should identify and target patients who respond best to I-EAET and develop tailored treatment to enhance treatment effects.

    Open access, https://www.sciencedirect.com/science/article/pii/S0022399922003531
     
    Andy, Nov 4, 2022
    #1
    Sean and Peter Trewhitt like this.
  2. Trish

    Trish Moderator Staff Member

    Messages:
    53,404
    Location:
    UK
    Good to see acknowledgement that CBT has only small short term effects on chronic somatic symptoms, by which I assume they mean physical symptoms.

    There seems to be an assumption in this abstract that chronic somatic symptoms are caused by trauma or conflict.

    I wonder to what extent all they are achieving here is to encourage patients to fill in questionnaires differently by interpreting their degree of suffering in a more 'acceptable' way.
     
    Trish, Nov 4, 2022
    #2
    Sean, JemPD, alktipping and 2 others like this.

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