A randomized controlled trial of brief psychoanalytic psychotherapy in patients with functional dyspepsia

Functional dyspepsia (FD) is a common cause of upper gastrointestinal symptoms and discomfort. The present study aimed to assess the effectiveness of brief core conflictual relationship theme (CCRT) psychoanalytic psychotherapy on changing gastrointestinal symptoms, alexithymia, and defense mechanisms in patients with FD. In a randomized controlled trial study, 49 patients with FD were randomly assigned to medical treatment with brief psychodynamic therapy (24 subjects) or medical treatment alone (25 subjects). Gastrointestinal symptoms, defense mechanisms, and alexithymia were assessed before the trial, after treatment, and at 1- and 12-month follow-ups. The results showed that brief psychodynamic therapy improved all of the gastrointestinal symptoms, including heartburn, nausea, fullness, bloating, upper abdominal pain, and lower abdominal pain, after treatment and at two follow-ups. The CCRT therapy significantly improved many psychological symptoms, including mature defenses, neurotic defenses, immature defenses, difficulties in identifying feelings, difficulties in describing feelings, and total alexithymia score. In conclusion, brief psychodynamic therapy is a reliable method to improve gastrointestinal symptoms, mature defenses, and alexithymia scores in patients with functional dyspepsia.