Using clinical patient characteristics to predict treatment outcome of cognitive behavior therapies for individuals with [MUS], 2022, Sarter et al

Full title: Using clinical patient characteristics to predict treatment outcome of cognitive behavior therapies for individuals with medically unexplained symptoms: A systematic review and meta-analysis

Highlights

• Meta-analyses of clinical patient predictors of the outcome of CBT for MUS.

• A higher symptom intensity predicts less favorable CBT outcome.

• A lower physical or social-emotional functioning predicts less favorable CBT outcome.

• A higher symptom duration or external reward predict less favorable CBT outcome.

• Outcome predictions did not differ between syndromes of MUS or levels of the study quality.

Abstract

Objective
For individuals with medically unexplained symptoms (MUS), cognitive behavioral therapy (CBT) is the best-evaluated treatment. This systematic review and meta-analyses identify clinical patient characteristics associated with the treatment outcome of CBT for MUS.

Methods
A systematic literature search (PubMed, PsycInfo, Web of Science) resulted in 53 eligible studies; of these 32 studies could be included in meta-analyses. Pooled correlation coefficients between predictors and treatment outcome were calculated with a random-effects model. Moderator analyses were conducted to examine differences between subgroups of MUS and different levels of methodological study quality.

Results
Meta-analyses demonstrated that individuals with higher symptom intensity (r = 0.38; p < 0.001), lower physical functioning (r = −0.29; p < 0.001), lower emotional and social functioning (r = −0.37; p < 0.001), more potential symptom-related incentives (r = −0.15; p = 0.001), or longer symptom duration (r = 0.10; p = 0.033) at the beginning of treatment reported less change of symptom severity until the end of therapy or higher end-of-treatment symptom severity. The pooled effect sizes did not differ between certain subgroups of MUS or between different levels of methodological quality.

Conclusion
Our findings indicated that clinical characteristics of MUS patients are associated with treatment outcome of CBT. We discuss how the results can be used to optimize and personalize future treatments for MUS.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0163834322000251

 

Pretty much literally: we worked a lot on this so you will take it or leave it.

What does it matter that it was evaluated more than anything else? It's useless. In fact it's been way over-evaluated, literally hundreds of identical attempts of the same thing, all showing the same: inconclusive. Being evaluated a lot doesn't mean a damn thing when all attempts are impossibly biased and methodology weak, but this is psychosocial, nothing actually matters.

But here they seem to glimpse that having ignored clinical features, they actually matter, despite having insisted for decades that they don't. Which is largely the fault of having a "best-evaluated treatment" that consists entirely of hot air. That's nothing to boast about. That's like putting up a pile of bad-smelling sand in a cooking competition and insisting you worked very hard on it and so deserve to win. Rubbish.

 

If they are referring to disability benefits, people who receive these financial compensation packages often have to produce objective indicators of disease. Thus, people receiving these likely have an underlying condition that wouldn’t subside with CBT, no matter how assiduously it’s been evaluated.

The apparent inability to even fathom these basic logical retorts further confirms the suspicion that BPS is a sectarian movement, rather than an academic approach.

 

Genius level thinking: people on disability are sicker on average than people who aren't, therefore if we eliminate disability benefits, fewer people will be recorded as ill. Also: eliminate hospitals, way too many people die there, clearly massive death traps.

Which is technically accurate, except the special kind of technically accurate that is both true and wrong.