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Cognitive behavioural therapy for medically unexplained physical symptoms: a randomised controlled trial

A E Speckens1, A M van Hemert, P Spinhoven

  • 1Department of Psychiatry, University Hospital, Leiden, Netherlands.

BMJ (Clinical Research Ed.)
|November 18, 1995
PubMed
Summary

Cognitive behavioural therapy (CBT) significantly improved recovery rates and reduced symptom intensity in patients with unexplained physical symptoms compared to optimized medical care. These positive effects were sustained at 12-month follow-up.

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Area of Science:

  • Psychiatry
  • General Medicine
  • Psychosomatic Medicine

Background:

  • Medically unexplained physical symptoms (MUPS) pose a significant challenge in general medical settings.
  • Optimized medical care alone may not fully address the complex nature of MUPS.

Purpose of the Study:

  • To evaluate the additional efficacy of cognitive behavioural therapy (CBT) for patients with MUPS.
  • To compare CBT plus optimized medical care against optimized medical care alone.

Main Methods:

  • A randomized controlled trial was conducted with 79 patients in a university hospital's general medical outpatient clinic.
  • Patients received either 6–16 sessions of CBT or optimized medical care, with assessments at 6 and 12 months.

Main Results:

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  • The CBT group showed higher recovery rates and reduced symptom intensity, sleep impairment, and frequency at 6 months.
  • Significant improvements were also observed in social and leisure activities and illness behavior.
  • These benefits were largely maintained at the 12-month follow-up.

Conclusions:

  • Cognitive behavioural therapy is a feasible and effective treatment for medically unexplained physical symptoms in primary care.
  • CBT offers a valuable therapeutic option for patients experiencing persistent physical symptoms without clear medical explanation.