Trial Report Online acceptance and commitment therapy (iACT) for adults with persistent physical symptoms – 3-month follow-up study of a... 2024 Lappalainen et al

Full title: Online acceptance and commitment therapy (iACT) for adults with persistent physical symptoms – 3-month follow-up study of a randomized controlled trial

Highlights

• This RCT (n = 103) examined whether online ACT + TAU was superior to TAU for PPS.
  
  
• Adults with PPS related to indoor environment, chronic fatigue or both were examined.
  
  
• The iACT+TAU group improved more in somatic, depressive and anxiety symptoms.
  
  
• Between-group effects were moderate to large (d = 0.71–1.09) at follow-up.
  
  
• iACT combined with TAU could be effective for treating these PPS conditions.
  

Abstract

Objective
Persistent physical symptoms (PPS) represent a major health problem affecting daily functioning. This RCT aimed to examine whether a guided Internet-based treatment based on acceptance and commitment therapy (ACT) provided additional benefits compared to Treatment as Usual (TAU) in reducing somatic complaints and psychological distress in adults with PPS.

Methods
A total of 103 adults with PPS related to indoor environments, chronic fatigue or both conditions were assigned to receive either either a 14-week intervention (video-based case conceptualization + Internet-based ACT) combined with TAU (iACT + TAU; n = 50) or TAU alone (n = 53). Somatic symptoms, depression, anxiety, insomnia, and psychological flexibility were assessed from pre-intervention to a 3-month follow-up. Additionally, the association between changes in psychological flexibility from pre- to post-intervention and changes in symptoms from pre to 3-month follow-up was explored. Analyses were conducted using a multigroup method with full information maximum likelihood estimator.

Results
The results revealed a significant interaction effect, indicating reductions in somatic symptoms and symptoms of depression and anxiety with moderate to large between-group effects (d = 0.71–1.09). No significant interaction effect was observed in insomnia and measures of psychological flexibility.

Conclusion
Internet-based ACT, when combined with Treatment as Usual, demonstrated efficacy for individuals with PPS associated with indoor environments and chronic fatigue. These findings are pertinent for primary healthcare providers, suggesting that the current treatment model could serve as a low-threshold first-line treatment option.

Open access, https://www.sciencedirect.com/science/article/pii/S0022399924002423

 

Protocol previously posted here, A randomized controlled trial protocol for persistent physical symptoms associated with indoor environment or chronic fatigue: 2023 Selinheimo et al

 

Statistical significance is the new clinical significance, because if you can't hit between the goal posts, just move the goalposts.

34% attrition rate. When you look at the questionnaire data, it's pretty much just noise with blips of difference here and there that are entirely expected when you try, for 12 weeks, to influence participants' responses on those questionnaires.

If you shovel crap long enough, you can report that you could be shoveling a lot of crap.

 

IT really would be cheaper for doctors to tell patients we do not know of any way to really help you but will try to reduce their symptom burden through proven treatments ie pain meds anti nausea etc.