Abstract:
BACKGROUND:Patients with medically unexplained symptoms (MUS) are difficult to treat and cause high health-care costs. Psychological interventions might be a beneficial option for treating patients with MUS, but evidence is inconsistent. This meta-analysis compares the effectiveness of psychological interventions for MUS - delivered either by psychotherapists (PTs) or by general practitioners (GPs) - with that of usual care. METHOD:We conducted a systematic review and meta-analysis on randomised controlled trials of psychological interventions for MUS. Physical symptoms were the primary outcome, and physical functioning and psychological symptoms were the secondary outcomes. We pooled between-group effect sizes (ESs) after the treatment and at the follow-up in random-effects meta-regressions and stratified meta-analyses. We repeated these analyses with the intervention provider, intervention dose, MUS severity and methodological quality as predictors of relative intervention effects. RESULTS:A total of 3,225 patients in 20 studies were analysed. After the treatment, small and significant ESs were found for all 3 outcome domains (ES range: 0.13-0.19, all p < 0.05). Psychological interventions were more beneficial for physical symptoms when delivered by PTs than by GPs (p = 0.02). There was no difference between PTs and GPs in terms of physical functioning and psychological symptoms. CONCLUSION:Psychological interventions are effective for patients with MUS, but the effects are small and most likely of short duration. Interventions that are delivered by PTs appear to have larger effects on unexplained physical symptoms than those delivered by GPs. Whether this superiority is due to a larger number of sessions of PT interventions remains unclear from our findings.
journal_name
Psychother Psychosomjournal_title
Psychotherapy and psychosomaticsauthors
Gerger H,Hlavica M,Gaab J,Munder T,Barth Jdoi
10.1159/000380914subject
Has Abstractpub_date
2015-01-01 00:00:00pages
217-26issue
4eissn
0033-3190issn
1423-0348pii
000380914journal_volume
84pub_type
杂志文章,meta分析,评审abstract::Pathological hyperprolactinaemia (PH) is significantly associated with: (1) paternal deprivation during childhood, (2) depression, (3) non-specific symptoms including obesity and weight gain. The clinical onset of the symptoms often follows pregnancy or a loss. Prolactin is an insulin antagonist which does not promote...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章,评审
doi:10.1159/000288585
更新日期:1992-01-01 00:00:00
abstract::The Toronto Alexithymia Scale (TAS) offers a reliable method to measure alexithymia, a personality construct describing individuals endorsing the inability to identify and report emotions, processing a minimal fantasy life, utilizing an analytic cognitive style, and tending to somatize. Utilizing four cohorts of both ...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000288608
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to find out whether alexithymia is common in frequently attending primary health care patients and whether alexithymia and psychological distress are associated in these patients. METHODS:Alexithymia was measured by the TAS-26 and psychological distress by the SCL-25 in a ra...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000289075
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Somatic illness and its consequences evoke strong emotions of various kinds. They may affect the course of illness and the treatment results through their physiological components. The purpose of the study was to explore emotional reactions to different kinds of illnesses and changes of these emotions over t...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000012348
更新日期:1999-01-01 00:00:00
abstract::It used to be fashionable to begin consideration of psychosomatics about philosophy of mind and body. Nowadays it is a topic about health and practical care of patients--principally about the psychological aspects of any illness. Pathogenesis is becoming understood with some risk factors clearly identifiable. The high...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章,评审
doi:10.1159/000288009
更新日期:1987-01-01 00:00:00
abstract::Little is known about prognostic factors in the treatment of bulimic patients. In the context of an ongoing study we looked at 1-year symptomatic outcome of 37 outpatients fulfilling DSM-III-R criteria for bulimia nervosa in relation to a variety of measures at first assessment. These included multiple measures of dep...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000288530
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Instruments that are intended to measure change over time need to emphasize sensitivity to change as a central property. The aims of this report are to test whether the MOODS-SR, a measure of mood spectrum symptomatology, is sensitive to changes during acute and continuation treatment of depression and wheth...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章,随机对照试验
doi:10.1159/000201937
更新日期:2009-01-01 00:00:00
abstract::Many child and adolescent psychotherapists are asked to work in specialized institutions (where the children are either interns or externs), with children presenting behaviour problems, learning difficulties, mental handicap or important psychosocial problems. They learn through diverse treatment forms, or parent acco...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000288344
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:There has been relatively little research on subthreshold eating disorders and factors which might promote their transition to eating disorders. METHODS:A sample consisting of 1,944 Swiss adolescents of both sexes, 14-19 years of age, was investigated for eating behavior (EAT-26), psychological (SCL-90-R) a...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000289091
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:In bulimia nervosa, more intense treatments are recommended if outpatient treatment fails. This is the first randomized controlled trial comparing the options of inpatient versus day clinic treatment. METHOD:Patients with severe bulimia nervosa were randomly assigned to inpatient or day clinic treatment of ...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章,随机对照试验
doi:10.1159/000206869
更新日期:2009-01-01 00:00:00
abstract::This paper presents the Social Phobia Psychotherapy Research Network. The research program encompasses a coordinated group of studies adopting a standard protocol and an agreed-on set of standardized measures for the assessment and treatment of social phobia (SP). In the central project (study A), a multicenter random...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000162299
更新日期:2009-01-01 00:00:00
abstract::It is stated that much psychoneuroendocrinological research is carried out that lacks a theoretical framework and therefore adds little to our current knowledge. Therefore, five research issues have been presented which need further exploration: (1) the temporal relation between subjective and biological stress respon...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章,评审
doi:10.1159/000288411
更新日期:1991-01-01 00:00:00
abstract::Relevance of an article is a highly desirable yet hardly predictable quality at the time of its publication. Article relevance is frequently measured by the impact factor of the journal where the article is published. Furthermore, impact factor, citation index and citation analysis are used as a measure of research pr...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000082020
更新日期:2005-01-01 00:00:00
abstract::Given the contradictory reports concerning psychophysiological reactivity of hypertensives this issue was reexamined. In contrast to the large majority of studies, the hypertensive sample should not be made up of patients in medical care and the control group should be comparable in all relevant aspects other than blo...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000288936
更新日期:1995-01-01 00:00:00
abstract::In the present study of 253 patients with chronic pain syndrome we have made a multidimensional approach. All patients have been included in the study independent of coexisting states of anxiety or depression. We included criteria for diagnosis, duration, generability and intensity of pain, anxiety and depression, psy...
journal_title:Psychotherapy and psychosomatics
pub_type: 临床试验,杂志文章
doi:10.1159/000288032
更新日期:1987-01-01 00:00:00
abstract::The purpose of this paper is to reflect on and to compare various psychoanalytic models which are used in the conceptualisation of the processes occurring in small psychotherapeutic groups. Three tendencies are roughly differentiated: (1) the tendency to analyse the individual patient in the group (Slavson, Wolfson an...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000287440
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:In spite of the connection of alexithymic characteristics to many stress-related disorders, little is known about the effects of these characteristics on the self-perception of stress, which may have functional value in the regulation of daily behavior. The present study assessed the influence of alexithymic...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000012341
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Clinicians and researchers synthesize data from randomized controlled trials (RCTs) of antidepressants to make conclusions about the efficacy of medications for depression. All treatments include nonspecific factors in addition to the specific effects of drugs, and study design may influence patient outcomes...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000209348
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Adherence to highly active antiretroviral treatment (HAART) is critical to long-term treatment success in patients infected with human immunodeficiency virus (HIV). However, the relationship between psychological variables and medication adherence is still poorly understood. The aim of this study was to inve...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000219525
更新日期:2009-01-01 00:00:00
abstract::Cognitive-behavioural therapy (CBT) programmes for bulimia nervosa (BN) have been considerably refined during the last 2 decades, and such a treatment is now extensively used. The present paper describes the treatment rationale and structure, and reviews the available evidence on its efficacy. Compared to any other ps...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章,评审
doi:10.1159/000012410
更新日期:2000-11-01 00:00:00
abstract::In addition to the diagnosis of symptoms we recently proposed the empirical analysis of psychodynamic levels; this paper aims at an empirical study of a third, and most essential, problem area: disturbances and/or regulatory processes of the self-system. Based on Deneke's newly developed questionnaire, 30 anorexia ner...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000288103
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Stress has been associated with the course of Tourette's syndrome (TS). METHODS:The case report presented aims to emphasize the effect a severe traumatic experience has on the expression of TS. RESULTS:Following an intense traumatic experience, combat-related, a relatively mild case of TS became intractabl...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000289057
更新日期:1996-03-01 00:00:00
abstract::The personality trait of alexithymia was assessed in 95 patients (35 male, 60 female) with affective illnesses, receiving lithium prophylactically, by means of Schalling-Sifneos Personality Scale (SSPS). The mean SSPS score was similar to that of the healthy population: only 8 patients had a score below 50 points. No ...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000288058
更新日期:1988-01-01 00:00:00
abstract::The aim of short-term dynamic psychotherapy is, through working with a central conflict and transference reactions, to obtain lasting changes based on cognitive and emotional understanding of the main dynamics of the central conflict, called insight. The aim of the present study was to construct a follow-up form that ...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000287850
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Stress reduction and comprehensive lifestyle modification programs have improved atherosclerosis and cardiac risk factors in earlier trials. Little is known about the impact of such programs on quality-of-life (QoL) and psychological outcomes. Given recent significant improvements in cardiac care, we evaluat...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000087781
更新日期:2005-01-01 00:00:00
abstract::Developmental trends in type A behavior and somatic risk factors of coronary heart disease were studied in 842 healthy adolescents and young adults. Type A behavior was measured using the AFMS and the somatic risk factors adopted were serum total cholesterol, LDL and HDL cholesterol, systolic blood pressure, diastolic...
journal_title:Psychotherapy and psychosomatics
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000288158
更新日期:1989-01-01 00:00:00
abstract::Adolescents are frequently entangled in a web of transitions during their developmental journey from child to adult. These modulations include physiological and psychological changes: individual, familial and social readjustments, and alterations in the evolving family group. Psychosomatic manifestations are often tar...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000287421
更新日期:1980-01-01 00:00:00
abstract::Verbal affective expression and psychometric variables were studied in a group of 5 duodenal ulcer and 6 irritable bowel patients. The aim was to assess the relevance of the alexithymia contruct to the distinction between both groups. Irritable bowel patients exhibited higher scores on Zung's depressiveness scale. Ale...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000287839
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:The study investigates individual differences in the mental representation of attachment and their impact on the cortisol response to psychosocial stress in idiopathic spasmodic torticollis (IST). It was hypothesized (a) that in IST insecure attachment is more prevalent than in a non-clinical control group an...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000012384
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Few studies to date have investigated whether in fact the prevalence of eating disorders (ED) and/or use of illicit drugs is higher among models than among other groups of females. METHOD:A group of 63 professional fashion models of various nationalities were studied by means of self-reported questionnaires...
journal_title:Psychotherapy and psychosomatics
pub_type: 杂志文章
doi:10.1159/000056285
更新日期:2002-05-01 00:00:00