Psychological Interventions for Health Anxiety and Somatic Symptoms

2020 ◽  
Vol 228 (2) ◽  
pp. 68-80 ◽  
Author(s):  
Ulrike Maass ◽  
Franziska Kühne ◽  
Jana Maas ◽  
Maria Unverdross ◽  
Florian Weck
Keyword(s):  
Somatic Symptom ◽  
Health Anxiety ◽  
Somatic Symptoms ◽  
Risk Of Bias ◽  
Post Treatment ◽  
Psychological Interventions ◽  
Treatment As Usual ◽  
Illness Anxiety Disorder ◽  
Illness Anxiety

Abstract. This study examined the effectiveness of psychological interventions for severe health anxiety (SHA) regarding somatic symptoms (SS) and health anxiety (HA). The databases Web of Science, EBSCO, and CENTRAL were searched on May 15, 2019, May 16, 2019, and August 5, 2019, respectively. Eighteen randomized controlled trials ( N = 2,050) met the inclusion criteria (i.e., hypochondriasis, illness anxiety disorder or somatic symptom disorder with elevated HA being assessed with validated interviews; use of standardized outcome measures). Two reviewers independently evaluated the studies’ risk of bias using the Revised Cochrane Risk-of-Bias Tool for randomized trials (RoB-2) tool. Overall, psychological interventions were significantly more effective than waitlist, treatment-as-usual, or placebo post-treatment ( gSS = 0.70, gHA = 1.11) and at follow-up ( gSS = 0.33, gHA = 0.70). CBT outperformed other psychological interventions or pharmacotherapy for HA post-treatment (Hedge’s  gHA = 0.81). The number of sessions did not significantly predict the effect sizes. In sum, psychological interventions were effective for SHA, but the generalizability of the results for SS is limited, because only two high-quality trials contributed to the comparisons.

Somatic symptom and related disorders

2015 ◽  
pp. 226-232
Author(s):  
Martin Brüne
Keyword(s):  
Somatic Symptom ◽  
Somatic Symptoms ◽  
Somatic Complaints ◽  
Conscious Awareness ◽  
Factitious Disorder ◽  
Somatic Symptom Disorder ◽  
Illness Anxiety Disorder ◽  
Somatic Illness ◽  
Illness Anxiety ◽  
Somatic Symptom Disorders

Somatic symptom disorders are characterized by the presentation of somatic complaints (somatization), often, but not necessarily, in the absence of a medical explanation of these sensations. The level of concern is generally disproportionate in relation to the severity of the somatic illness. Behaviourally, somatic symptom disorder entails signals that call for help and attention from others. Evolutionary considerations of why people present with somatic symptoms in the absence of a medical cause suggest that this behaviour could reflect a strategy to manipulate others in order to evoke care. Signals that aim at eliciting care from others are more persuasive if the ‘real’ intention is hidden from conscious awareness. Thus, self-deception may be involved in the presentation of somatic symptoms. Within the spectrum of somatic symptom and related disorders, the degree of self-deception may vary from high, as in illness anxiety disorder, to relatively low, as in factitious disorder.

Pregnancy-specific health anxiety: symptom or diagnosis?

2019 ◽  
Vol 27 (5) ◽  
pp. 288-293
Author(s):  
Amy Leigh Rathbone ◽  
Julie Prescott
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Symptom ◽  
Somatic Symptom ◽  
Health Anxiety ◽  
Somatic Symptom Disorder ◽  
Human Response ◽  
Illness Anxiety Disorder ◽  
Clinical Diagnoses ◽  
Illness Anxiety ◽  
Specific Health

Anxiety is an innate human response to situations that cause fear, worry or concern. One such type is health anxiety. Health anxiety is a term derived from hypochondriasis and divided into two disorders: illness anxiety disorder and somatic symptom disorder. Symptoms can range from mild-to-moderate expressions of worry to clinical diagnoses. Previous research has shown pregnancy-specific anxiety to be an autonomous anxiety disorder. When a woman conceives, immediate somatic changes are experienced, and although all pregnancies are different, these changes could cause either illness anxiety disorder or somatic symptom disorder. This review explores the possibility of pregnancy-specific health anxiety in greater detail.

scholarly journals Assessing the Effectiveness of Brief and Low Intensity Psychological Interventions for Medically Unexplained Symptoms and Health Anxiety: A Systematic Review of the Literature

2020 ◽  
Author(s):  
Orla McDevitt-Petrovic ◽  
Karen Kirby
Keyword(s):  
Systematic Review ◽  
Health Anxiety ◽  
Medically Unexplained Symptoms ◽  
Future Research ◽  
Psychological Interventions ◽  
Review Of The Literature ◽  
Illness Anxiety Disorder ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Illness Anxiety

This chapter presents a systematic review of the literature to assess the effectiveness of brief psychological interventions for medically unexplained symptoms (MUS)/somatic symptom disorder, non-cardiac chest pain, and illness anxiety disorder or health anxiety (HA). Google Scholar, PubMed, and Web of Science were searched as data sources. Reference lists were subsequently examined for other relevant articles. Studies were assessed according to specified inclusion criteria and extracted according to PRISMA guidelines. A total of 23 studies were included in the final synthesis. Significant effects for intervention groups relative to control groups were reported in 19 studies, whilst 4 studies did not determine any significant benefits of interventions compared with controls. All of the brief interventions (CBT, psychosocial, psychophysiological, psychosomatic, relaxation and group therapy), with the exception of metaphor therapy, showed significant effects relative to controls in at least one study. The evidence suggests that brief psychological interventions, more specifically time limited CBT based interventions may be effective in treating HA and MUS with psychological distress. Findings are comparable with other reviews. Future research may facilitate the piloting of an intervention, and there remains a need to provide more robust evidence of cost effectiveness.

scholarly journals Internet-Administered Emotional Awareness and Expression Therapy for Somatic Symptom Disorder With Centralized Symptoms: A Preliminary Efficacy Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Daniel Maroti ◽  
Josefine Ek ◽  
Rose-Marie Widlund ◽  
Howard Schubiner ◽  
Mark A. Lumley ◽  
...  
Keyword(s):  
Somatic Symptom ◽  
Functional Disability ◽  
Psychiatric Symptoms ◽  
Somatic Symptoms ◽  
Emotional Awareness ◽  
Post Treatment ◽  
Somatic Symptom Disorder ◽  
Efficacy Trial ◽  
Face To Face

Background: There is growing evidence that trauma, psychosocial conflict, and difficulties with emotional processing contribute to centralized somatic symptoms. Emotional Awareness and Expression Therapy (EAET) was developed to address these factors and reduce symptoms, and EAET has shown efficacy in face-to-face formats. No trial of an internet-delivered EAET (I-EAET) exists, however, so we developed such an intervention and conducted an uncontrolled feasibility and potential efficacy trial of I-EAET for patients with Somatic Symptom Disorder (SSD) with centralized symptoms (SSD-CS).Method: After screening potential participants, a sample of 52 patients (50 women, two men; age M = 49.6, SD = 11.9) diagnosed with SSD-CS initiated treatment. I-EAET consisted of nine weekly modules focused on psychoeducation, emotional awareness and exposure, and anxiety regulation with self-compassion. Therapists communicated with each patient by email for about 20 min per week during treatment, answering questions and giving feedback on homework assignments. Patients completed measures of somatic symptoms, depression, anxiety, trauma-related symptoms, and functional disability before treatment and again at post-treatment and 4-month follow-up.Results: A large reduction in somatic symptoms (PHQ-15) occurred pre-to post-treatment (d = 1.13; 95% CI: 0.84–1.47) which was fully maintained at 4-month follow-up (d = 1.19; 95% CI: 0.88–1.56). Twenty-three percent of the patients at post-treatment and 27% at follow-up achieved a 50% or greater reduction in somatic symptoms, and about 70% achieved a minimally important clinical difference. In addition, at post-treatment, there were small to medium reductions (d's from 0.33 to 0.72) in anxiety (GAD-7), depression (PHQ-9), trauma-related symptoms (PCL-5), and functional disability (Sheehan Disability Scale). For all of these secondary outcomes, improvements were slightly to substantially larger at follow-up than at post-treatment (d's from 0.46 to 0.80).Conclusion: I-EAET appears to be a feasible treatment for adults with SSD and centralized symptoms, resulting in substantial and durable improvement not only in somatic symptoms but in other psychiatric symptoms and functioning. Controlled trials are needed determine the effects of I-EAET specifically and how this approach compares to face-to-face EAET and to other internet-delivered treatments, such as cognitive-behavioral interventions. Research should also identify treatment responders and mechanisms of change in EAET.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04122846.

Historische Entwicklung, Diagnostik und Klassifikation der Somatoformen Störungen – Vergleich von ICD-10, DSM-IV-TR und DSM-5

2014 ◽  
Vol 11 (03) ◽  
pp. 149-155
Author(s):  
M. Zaudig
Keyword(s):  
Anxiety Disorder ◽  
Somatic Symptom ◽  
Somatic Symptom Disorder ◽  
Historische Entwicklung ◽  
Dsm 5 ◽  
Illness Anxiety Disorder ◽  
Icd 10 ◽  
Dsm Iv ◽  
Illness Anxiety

ZusammenfassungDer vorliegende Artikel beschreibt die aktuellen diagnostischen Entwicklungen im Bereich der Somatoformen Störung unter Zugrundelegung der aktuellen S3-Leitlinien für „Nichtspezifische funktionelle und somatoforme Körperbeschwerden“ und der historischen Entwicklung der Somatoformen Störungen (einschließlich der Hypochondrie). Neben einem Vergleich von ICD-10 mit DSM-IV-TR und DSM-5 werden die neuen Kriterien für Somatic Symptom Disorder und Illness Anxiety Disorder (vormals Hypochondrie) nach DSM-5 vorgestellt und diskutiert.

scholarly journals Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 9 (10) ◽  
pp. 3246
Author(s):  
Juan P. Sanabria-Mazo ◽  
Jesus Montero-Marin ◽  
Albert Feliu-Soler ◽  
Virginia Gasión ◽  
Mayte Navarro-Gil ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Post Treatment ◽  
Effect Sizes ◽  
Control Group ◽  
Active Control Group ◽  
Treatment As Usual ◽  
Randomized Controlled ◽  
Pilot Randomized Controlled Trial

The lack of highly effective treatments for fibromyalgia (FM) represents a great challenge for public health. The objective of this parallel, pilot randomized controlled trial (RCT) was two-fold: (1) to analyze the clinical effects of mindfulness plus amygdala and insula retraining (MAIR) compared to a structurally equivalent active control group of relaxation therapy (RT) in the treatment of FM; and (2) to evaluate its impact on immune-inflammatory markers and brain-derived neurotrophic factor (BDNF) in serum. A total of 41 FM patients were randomized into two study arms: MAIR (intervention group) and RT (active control group), both as add-ons of treatment as usual. MAIR demonstrated significantly greater reductions in functional impairment, anxiety, and depression, as well as higher improvements in mindfulness, and self-compassion at post-treatment and follow-up, with moderate to large effect sizes. Significant decreases in pain catastrophizing and psychological inflexibility and improvements in clinical severity and health-related quality of life were found at follow-up, but not at post-treatment, showing large effect sizes. The number needed to treat was three based on the criteria of ≥50% Fibromyalgia Impact Questionnaire (FIQ) reduction post-treatment. Compared to RT, the MAIR showed significant decreases in BDNF. No effect of MAIR was observed in immune-inflammatory biomarkers (i.e., TNF-α, IL-6, IL-10, and hs-CRP). In conclusion, these results suggest that MAIR, as an adjuvant of treatment-as-usual (TAU), appears to be effective for the management of FM symptoms and for reducing BDNF levels in serum.

scholarly journals Exposure-based cognitive–behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial

2016 ◽  
Vol 209 (5) ◽  
pp. 407-413 ◽  
Author(s):  
Erik Hedman ◽  
Erland Axelsson ◽  
Erik Andersson ◽  
Mats Lekander ◽  
Brjánn Ljótsson
Keyword(s):  
Somatic Symptom ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Somatic Symptom Disorder ◽  
Dsm 5 ◽  
Internet Treatment ◽  
Cognitive Behavioural ◽  
Illness Anxiety Disorder ◽  
Illness Anxiety ◽  
Randomised Controlled

BackgroundIn DSM-5 two new diagnoses, somatic symptom disorder (SSD) and illness anxiety disorder (IAD), have replaced DSM-IV hypochondriasis. There are no previous treatment studies for these disorders. Cognitive–behavioural therapy (CBT) delivered as therapist-guided or unguided internet treatment or as unguided bibliotherapy could be used to increase treatment accessibility.AimsTo investigate the effect of CBT delivered as guided internet treatment (ICBT), unguided internet treatment (U-ICBT) and as unguided bibliotherapy.MethodA randomised controlled trial (RCT) where participants (n= 132) with a diagnosis of SSD or IAD were randomised to ICBT, U-ICBT, bibliotherapy or to a control condition on a waiting list (trial registration: Clinicaltrials.gov identifier NCT01966705).ResultsCompared with the control condition, all three treatment groups made large and significant improvements on the primary outcome Health Anxiety Inventory (between-groupdat post-treatment was 0.80–1.27).ConclusionsICBT, U-ICBT and bibliotherapy can be highly effective in the treatment of SSD and IAD. This is the first study showing that these new DSM-5 disorders can be effectively treated.

Somatic Symptom Disorders: a new approach in DSM-5

2013 ◽  
Vol 10 (01) ◽  
pp. 30-32 ◽  
Author(s):  
J. E. Dimsdale
Keyword(s):  
Somatic Symptom ◽  
Somatoform Disorders ◽  
Classification Criteria ◽  
New Classification ◽  
Special Aspect ◽  
New Approach ◽  
Dsm 5 ◽  
Illness Anxiety Disorder ◽  
Illness Anxiety ◽  
Somatic Symptom Disorders

SummaryFollowing a brief historic discourse, problems with the current use and concepts the of somatoform disorders are described. The rationale for substituting the term „somatoform“ with „somatic symptom“ in DSM5 is explained and the new classification criteria for the group of “somatic symptom related disorders” are described, which include severity ratings. A special aspect is that “Illness anxiety disorder” is introduced as a new diagnostic entity in DSM-5.

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