Early response in cognitive-behavior therapy for syndromes of medically unexplained symptoms

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dc.contributor.author Kleinstaeuber, Maria en
dc.contributor.author Lambert, MJ en
dc.contributor.author Hiller, W en
dc.coverage.spatial England en
dc.date.accessioned 2017-11-29T03:17:27Z en
dc.date.available 2017-05-05 en
dc.date.issued 2017-05-25 en
dc.identifier.citation BMC Psychiatry 17(1):195 25 May 2017 en
dc.identifier.issn 1471-244X en
dc.identifier.uri http://hdl.handle.net/2292/36591 en
dc.description.abstract BACKGROUND: Early dramatic treatment response suggests a subset of patients who respond to treatment before most of it has been offered. These early responders tend to be over represented among those who are well at termination and at follow-up. Early response patterns in psychotherapy have been investigated only for a few of mental disorders so far. The main aim of the current study was to examine early response after five therapy-preparing sessions of a cognitive behavior therapy (CBT) for syndromes of medically unexplained symptoms (MUS). METHODS: In the context of a randomized, waiting-list controlled trial 48 patients who suffered from ≥3 MUS over ≥6 months received 5 therapy-preparing sessions and 20 sessions of CBT for somatoform disorders. They completed self-report scales of somatic symptom severity (SOMS-7 T), depression (BDI-II), anxiety (BSI), illness anxiety and behavior (IAS) at pre-treatment, after 5 therapy-preparing sessions (FU-5P) and at therapy termination (FU-20 T). RESULTS: The current analyses are based on data from the treatment arm only. Repeated measure ANOVAs revealed a significant decrease of depression (d = 0.34), anxiety (d = 0.60), illness anxiety (d = 0.38) and illness behavior (d = 0.42), but no change of somatic symptom severity (d = -0.03) between pre-treatment and FU-5P. Hierarchical linear multiple regression analyses showed that symptom improvements between pre-treatment and FU-5P predict a better outcome at therapy termination for depression and illness anxiety, after controlling for pre-treatment scores. Mixed-effect ANOVAs revealed significant group*time interaction effects indicating differences in the course of symptom improvement over the therapy between patients who fulfilled a reliable change (i.e., early response) during the 5 therapy-preparing sessions and patients who did not reach an early reliable change. Demographic or clinical variables at pre-treatment were not significantly correlated with differential scores between pre-treatment and FU-5P (-.23 ≤ r ≤ .23). CONCLUSIONS: Due to several limitations (e.g., small sample size, lack of a control group) the results of this study have to be interpreted cautiously. Our findings show that reliable changes in regard to affective-cognitive and behavioral variables can take place very early in CBT of patients with distressing MUS. These early changes seem to be predictive of the outcome at therapy termination. Future studies are needed in order to replicate our results, and to identify mechanisms of these early response patterns in somatoform patients. TRIAL REGISTRATION: ISRCTN. ISRCTN17188363 . Registered retrospectively on 29 March 2007. en
dc.language eng en
dc.publisher BioMed Central en
dc.relation.ispartofseries BMC Psychiatry en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1471-244X/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject CBT en
dc.subject Cognitive-behavior therapy en
dc.subject Early response en
dc.subject MUS en
dc.subject Medically unexplained symptoms en
dc.title Early response in cognitive-behavior therapy for syndromes of medically unexplained symptoms en
dc.type Journal Article en
dc.identifier.doi 10.1186/s12888-017-1351-x en
pubs.issue 1 en
pubs.volume 17 en
dc.description.version VoR - Version of Record en
dc.rights.holder Copyright: The authors en
dc.identifier.pmid 28545580 en
pubs.publication-status Published online en
dc.rights.accessrights http://purl.org/eprint/accessRights/OpenAccess en
pubs.subtype Article en
pubs.elements-id 644299 en
dc.identifier.eissn 1471-244X en
dc.identifier.pii 10.1186/s12888-017-1351-x en
pubs.number 195 en
pubs.record-created-at-source-date 2017-11-29 en
pubs.online-publication-date 2017-05-25 en
pubs.dimensions-id 28545580 en

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