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Guided self-help for functional (psychogenic) symptoms: a randomized controlled efficacy trial.

M Sharpe¹, J Walker, C Williams

¹University of Edinburgh, Edinburgh, Scotland, UK. michael.sharpe@psych.ox.ac.uk

|July 29, 2011

Summary

Cognitive-behavioral therapy-based guided self-help (GSH) significantly improved health outcomes for patients with functional neurologic symptoms compared to usual care alone. This accessible treatment approach offers a feasible and effective option for improving patient well-being.

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Area of Science:

Neurology
Psychiatry
Clinical Psychology

Background:

Functional neurologic symptoms are prevalent in neurology clinics.
Cognitive-behavioral therapy (CBT) is an effective treatment but faces implementation challenges.
Guided Self-Help (GSH) offers a potential solution to improve access to CBT.

Purpose of the Study:

To test the hypothesis that adding CBT-based GSH to usual care (UC) improves outcomes in patients with functional symptoms.
To evaluate the efficacy and feasibility of CBT-based GSH in a real-world clinical setting.

Main Methods:

A randomized trial was conducted in two UK neurology services.
Outpatients with functional symptoms were randomized to UC or UC plus GSH.
GSH involved a self-help manual and four 30-minute guidance sessions.

Main Results:

Participants receiving GSH reported significantly greater improvement in self-rated general health at 3 months (p=0.016).
The number needed to treat was 8, indicating a modest but significant effect.
At 6 months, improvements in symptom reduction and physical functioning persisted.

Conclusions:

CBT-based GSH is a feasible and efficacious intervention for functional neurologic symptoms.
This approach demonstrates potential for wider implementation in clinical practice.
Further research is warranted to explore long-term effects and optimal delivery.