scholarly journals A systematic review of randomised controlled trials using psychological interventions for children and adolescents with medically unexplained symptoms: A focus on mental health outcomes

2019 ◽  
Vol 25 (1) ◽  
pp. 273-290 ◽  
Author(s):  
Christine O’Connell ◽  
Roz Shafran ◽  
Sophie Bennett
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Children And Adolescents ◽  
Medically Unexplained Symptoms ◽  
Mental Health Outcomes ◽  
Psychological Interventions ◽  
Medically Unexplained ◽  
Mental Health Difficulties ◽  
Unexplained Symptoms ◽  
Randomised Controlled

Background: Medically unexplained symptoms affect between 4% and 20% of children and adolescents; 30–60% of these children also experience mental health difficulties. Trials and reviews have focussed on physical gains in this population, often overlooking mental health outcomes. Objectives: To use a systematic review methodology guided by the PRISMA checklist to (1) investigate the effectiveness of psychological interventions for mental health difficulties in children and adolescents with medically unexplained symptoms and (2) identify aspects of interventions associated with their success. Methods: Randomised controlled studies investigating the impact of psychological interventions on mental health in children and adolescents with medically unexplained symptoms were included. Systematic searches of PsycINFO, MEDLINE and CINAHL were undertaken from inception to January 2018. Studies were appraised using the quality appraisal checklist. A qualitative synthesis of studies was completed. Results: In all, 18 studies were identified. Interventions targeting parental responses to illness and family communication appeared to have the best outcomes. Conclusions: Psychological interventions may be effective in improving mental health outcomes within this population; however, evidence for the efficacy of these interventions is limited due to a high risk of bias within the majority of reviewed studies. Future research using rigorous methodology and non–cognitive behavioural therapy interventions is recommended.

The Fort Bragg continuum of care for children and adolescents: Mental health outcomes over 5 years.

2000 ◽  
Vol 68 (4) ◽  
pp. 710-716 ◽  
Author(s):  
Leonard Bickman ◽  
E. Warren Lambert ◽  
Ana Regina Andrade ◽  
Roberto V. Penaloza
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Children And Adolescents ◽  
Continuum Of Care ◽  
Mental Health Outcomes ◽  
Fort Bragg

Factors influencing adherence to therapeutic recommendations made after diagnostic reassessment of medically unexplained symptoms in children and adolescents

2019 ◽  
Vol 25 (1) ◽  
pp. 62-77
Author(s):  
Sam LB Bonduelle ◽  
Johan Vanderfaeillie ◽  
Katrien Denijs ◽  
Annik Lampo ◽  
Lindita Imeraj
Keyword(s):  
Children And Adolescents ◽  
Influencing Factors ◽  
Somatoform Disorders ◽  
Medically Unexplained Symptoms ◽  
Primary Outcome Measure ◽  
Influential Factors ◽  
Cross Sectional ◽  
Medically Unexplained ◽  
Therapeutic Recommendations ◽  
Unexplained Symptoms

Background: Medically unexplained symptoms (MUS) are common among children and adolescents and may be highly impairing. Even after long diagnostic and/or therapeutic trajectories, many of these children and their parents feel dissatisfied with the advice and therapies they were given. Objectives: After a 2-week hospitalisation for somatic and psychiatric reassessment, children and their families were given recommendations for further treatment. This study evaluates which of these recommendations were carried out (primary outcome measure) and which factors influenced the (non-)adherence to therapeutic advice. Methods: Parents of 27 children aged 7–17 with impairing MUS took part in a structured telephone survey to assess adherence to and perceived effectiveness of therapeutic recommendations (cross-sectional study). Influencing factors were analysed retrospectively. Results: Psychotherapy was recommended to all 27 patients and their families; 19 of them (70.4%) carried out this advice. When physiotherapy was recommended, adherence proved lower (6/22 children; 27.3%). No influencing factors were found to have a statistically significant correlation with adherence. Effect sizes may be indicative of clinically relevant influential factors, but should be considered cautiously. Conclusion: Results suggest that more efforts need to be made to ensure adherence to therapeutic recommendations. Known risk factors for non-adherence to treatments for chronic somatic disorders may not apply for children with somatoform disorders.

scholarly journals Cluster randomised controlled trial of training practices in reattribution for medically unexplained symptoms

2007 ◽  
Vol 191 (6) ◽  
pp. 536-542 ◽  
Author(s):  
Richard Morriss ◽  
Christopher Dowrick ◽  
Peter Salmon ◽  
Sarah Peters ◽  
Graham Dunn ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Medically Unexplained Symptoms ◽  
Cluster Randomised Controlled Trial ◽  
Patient Communication ◽  
Doctor Patient Communication ◽  
Cluster Randomised ◽  
Medically Unexplained ◽  
Unexplained Symptoms ◽  
Randomised Controlled

BackgroundReattribution is frequently taught to general practitioners (GPs) as a structured consultation that provides a psychological explanation for medically unexplained symptoms.AimsTo determine if practice-based training of GPs in reattribution changes doctor–patient communication, thereby improving outcomes in patients with medically unexplained symptoms of 3 months' duration.MethodCluster randomised controlled trial in 16 practices, 74 GPs and 141 patients with medically unexplained symptoms of 6 hours of reattribution training v. treatment as usual.ResultsWith training, the proportion of consultations mostly consistent with reattribution increased (31 v. 2%, P=0.002). Training was associated with decreased quality of life (health thermometer difference −0.9, 95% CI −1.6 to −0.1; P=0.027) with no other effects on patient outcome or health contacts.ConclusionsPractice-based training in reattribution changed doctor–patient communication without improving outcome of patients with medically unexplained symptoms.

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