The role of illness perception and behaviour in the treatment of adolescents with multisystem functional somatic disorders:... 2025 Kallesøe et al

[Andy]

Full title: The role of illness perception and behaviour in the treatment of adolescents with multisystem functional somatic disorders: a post hoc mediation analysis of the AHEAD trial

ABSTRACT​

Psychological interventions can reduce symptom load and disability in adolescents with various functional somatic disorders (FSD). However, mechanisms of change are less investigated, especially in those with multisystem symptomatology.

In a post-hoc analysis, illness perception, illness behaviour, and psychological inflexibility (experiential avoidance and fusion) were examined as mediators of changes in self-perceived physical health in adolescents 3 months after receiving group-based Acceptance and Commitment Therapy versus Enhanced Usual Care. Baseline levels of proposed mediators were also assessed for moderation effects. Data from 91 adolescents (15–19 years) with multisystem FSD (duration ≥1 year) from the RCT “ACT for Health in Adolescents” (AHEAD) were used in a classic mediation analysis. Mediators were measured at baseline (before assessment), 5.5 months (2 weeks after end-of-treatment), and 8 months (3 months after end-of-treatment).

Improvements in negative illness perceptions and psychological inflexibility (experiential avoidance) mediated the effect of AHEAD on physical health at 8 months. The mediation effect increased with higher baseline levels, but the moderation effects were non-significant. AHEAD reduced negative illness perception and psychological inflexibility (experiential avoidance) and, consequently, improved physical health in adolescents with multisystem FSD. Reducing these factors may be important treatment targets in future treatment programmes for adolescents with FSD.

Open access

 

[Andy]

Depending on the main symptom presentation and the medical specialisation’s classification system, FSD covers a spectrum of symptom descriptors and functional somatic syndromes in somatic health care or bodily distress disorder (ICD-11) and somatic symptom disorder (DSM-5) in psychiatric health care (Burton et al., Citation2020). The most prevailing diagnoses in the paediatric populations include chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), tension-type headache, idiopathic pain, and juvenile fibromyalgia.

 

[rvallee]

So this seems to be a strategy in recent years, of doing disguised 'pragmatic trials' that get presented as some sort of study. They still do the traditional trials thing with the same traditional content, but they add some layer of pretending to be studying another concept, all rolled into one.

It avoids the negatives of reporting on failed trials, while pretending like they're doing research, even though the only thing that changed is how they frame it. But of course if they ever have a tiny positive blip, by chance or with enough bias, they can report is as a successful trial. Very devious and dishonorable, but that's "Imagine a world"-based medicine for ya.