Internet-delivered emotional awareness and expression therapy for somatic symptom disorder: one year follow-up 2025 Maroti et al

Objective: We examined whether the treatment effects from a previous RCT of Internet-delivered Emotional Awareness and Expression Therapy (I-EAET) for somatic symptom disorder were maintained 12 months after treatment.

Method: 12-month assessments of self-reported somatic symptoms, pain severity, and several secondary outcomes were compared with baseline and post-treatment levels within the I-EAET condition only, given that the waitlist control condition had already received treatment. Twenty-eight out of the original 37 participants (76%) in the I-EAET condition provided follow-up data.

Results: The beneficial effects of I-EAET on somatic symptoms observed at post-treatment were maintained at the 12-month follow-up (d = -0.22, 95% CI: -0.72 to 0.28), as well as for pain intensity (d = -0.02, 95% CI: -0.52 to 0.48). From pre-treatment to 12-month follow-up, there was a medium effect on somatic symptoms (d = 0.74, 95% CI 0.23 to 1.24), and a small, non-significant effect for pain intensity (d = 0.43, 95% CI -0.06 to 0.93). Response rates (at least 50% symptom reduction) at 12-month follow-up were 25% for somatic symptoms, and 12% for pain intensity.

Conclusion: I-EAET seems to have positive long-term effects for somatic symptom disorder. Larger studies with controls and comparisons to other treatments are needed.

Open access

 

Discussion thread for the referenced RCT, Internet-based emotional awareness and expression therapy for somatic symptom disorder: A randomized controlled trial 2022 Maroti et al

 

All 37 participants were included in the effect size analyses, applying intention to treat. The online software Psychometrica (19) was used for all effect size analyses. Welch tests, with SPSS 26 (20), were used for significance testing, comparing pre- and post-treatment to 12-month follow-up. Effect sizes in the range of 0.20–0.49 were considered small, 0.50–0.79 medium, and over 0.80 large (21).

Substantial response to treatment was defined as 50% or greater symptom reduction from pre- to post-treatment and to follow-up for each of the two primary outcomes (PHQ-15/somatic symptoms and BPI-4/pain intensity). Chi-square tests were conducted to examine condition differences in prevalence of substantial responders, using Psychometrica (19). Participants not providing follow-up data were excluded from these responder analyses.

The original trial registration noted that we would assess sleep-related outcomes (Epworth Sleepiness Scale, Insomnia Severity Index) and functional impairment (Sheehan Disability Scale); however, these measures were not included at the 12-month follow-up, due to research error. See Maroti et al. (12) for further elaboration.
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28 of 37 (76%) provided data for the two primary outcomes, and 26 of 37 (70%) provided data for three secondary outcomes.

25 % and 12 % response rate with 24 % drop-put. What a success!