Psychosocial treatments for employees with non-specific and persistent physical symptoms associated with indoor air, 2020, Selinheimo et al

[Andy]

"Highlights"
• Study of the effects of treatments on persistent symptoms associated with indoor air.
• Persistent physical symptoms associated with indoor air lack treatment options.
• Participants positively evaluated the treatments, particularly CBT.
• Signs of depression and insomnia might be undertreated in these patients.

Abstract
Objective
Persistent physical symptoms (PPS) associated with indoor air without an adequate pathophysiological- or environmental-related explanation may lead to work disability and decreased health-related quality of life (HRQoL). We attempted to assess the effect of cognitive behavioural therapy (CBT) for PPS and also psychoeducation (PE) on these symptoms involving disability.

Method
The intention-to-treat (ITT) sample included 52 employees recruited from an occupational healthcare service randomised as either controls undergoing treatment as usual (TAU) or TAU enhanced with CBT or PE. The primary outcome was HRQoL measuring the severity of symptoms and restrictions in everyday life caused by them. Secondary outcomes included depressive, anxiety and insomnia symptoms, and intolerance to environmental factors, assessed at baseline and at 3-, 6- and 12-month follow-ups.

Results
At the 12-month follow-up assessment point, no statistically significant differences between treatments emerged following adjustment for gender, age, and HRQoL before the waiting period in the ITT analysis [F(2,46)=2.89, p=.07]. The secondary analysis revealed a significant improvement in HRQoL in the combined intervention group as compared with controls [F(1,47)=5.06, p=.03, g=0.41]. In total, 15% of participants dropped out during follow-up.

Conclusions
The results suggest that CBT for PPS or PE might not have a robust effect on HRQoL in PPS associated with indoor air, but the study did not achieve the planned power. Despite difficulties during the recruitment process, the final dropout rates remained low, and participants positively evaluated CBT, suggesting that it represents an acceptable treatment to them.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0022399919306683
Sci hub, https://sci-hub.tw/10.1016/j.jpsychores.2020.109962

 

[Trish]

So the treatments didn't work, but that's OK because the participants found the treatment acceptable.
Funny how they always have to put a positive spin on null results.

 

[Sean]

Results
At the 12-month follow-up assessment point, no statistically significant differences between treatments emerged...

Conclusions
...and participants positively evaluated CBT, suggesting that it represents an acceptable treatment to them.

The treatment being ineffective renders the question of acceptability irrelevant.

 

[Sean]

Funny how they always have to put a positive spin on null results.

Seems to have worked for them so far.

 

[rvallee]

The framing is bizarre: symptoms associated with indoor air. Who makes the association? Baseless assumptions about health anxiety, it seems:

Some evidence suggests that modern health worries related to environmental factors contribute to persistent physical outcomes resulting from a focus on bodily symptoms

What evidence? Some. People are saying, I guess. So the "association" is entirely made by the researchers, who then blame it on health anxiety in patients. Talk about eating your cake and having it too. Of course the only relevant thing here is "focus on bodily symptoms", the same old tripe as always and, as always, CBT is the answer to a question no one was asking.

Since the "indoor air" part is completely superfluous, this is simply yet another CBT for MUS (oh, I'm sorry, I guess it's SSD now, rebranding and all), same as every other, useless as every other, irrelevant as every other. I have no idea why they think it's relevant that a useless thing is "acceptable". You can make almost anything acceptable in a clinical context where you instruct people to do something. Feng shui is acceptable to some. Astrology is acceptable to some. Hell, hazing is acceptable to some. Completely irrelevant.

I also have no idea what is psychosocial about CBT. It's 100% psychological, just say it, nobody cares and you look like a bunch of charlatans when you misrepresent your intent like that.

 

[Trish]

Surely if you want to test if people are affected by indoor air, you'd open the windows or send them outside, not give them CBT.

 

[Snowdrop]

I'm scratching my head wondering how CBT for low quality indoor air managed to gain any traction as an idea with anyone.

Clearly somebody is breathing some funny air.

 

[rvallee]

Surely if you want to test if people are affected by indoor air

Which also happens to be everyone.

Next up: a study on a subset of people who eat food?

 

[alktipping]

probably a rehash of sick building syndrome . very popular with bs artist in the 90s I think . no body bothered checking for all the toxic products that are commonly used in modern manufacturing paint containing fire retardants and such .

 

[NelliePledge]

The employers could start by making sure that buildings are properly cleaned and ventilated especially if they are going to expect people to work in air conditioned offices. Sick buildings notoriously spreading legionnaires through A/c. I worked in a building that had pigeons roosting on the glass roof which wasn’t a/c and had a system of air circulation including some vents on the roof. Some of us in certain parts on the top floor would occasionally come in to find one or two pigeon feathers on the desk. This was of course complained about and management got in some health & safety expert who did testing and reckoned there was no risk from this. Yeah right. In the end they had to put netting on the roof to stop the pigeons roosting.

This research is just to support employers in blaming employees for being ill. Same old story

 

[Cheshire]

 

[rvallee]

The Onion is such a treasure. They seriously have a habit of better capturing painful truths than most of the experts combined. This is seriously gold.