Somatoform

Allen, Lesley A. and Robert L. Woolfolk. “Cognitive Behavioral Therapy for Somatoform Disorders.” Psychiatric Clinics of North America, Vol. 33, Issue 3 (September 2010): 579-593.

Correspondence Address:
Department of Psychiatry, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, 671 Hoes Lane, Piscataway, NJ 08854, USA. allenla@umdnj.edu

Abstract
“Patients presenting with somatoform disorders often incur excessive health care charges and fail to respond to standard treatment. The purpose of this article is to provide an overview of the diagnostic criteria and demographic and clinical characteristics of each somatoform disorder and to examine the research assessing the efficacy of cognitive behavioral therapy (CBT) for each disorder. The review shows that CBT has received some empirical support for somatization, hypochondriasis, and body dysmorphic disorder. However, there are few data on the impact of treatment on health care use, especially when the cost of CBT is factored into the equation. Too few methodologically sound studies have been published on the treatment of conversion disorder or of pain disorder to make any conclusions.”

Barsky, A., & Ahern, D. K. (2004). Cognitive behavior therapy for hypochondriasis: A randomized Controlled Trial. Journal of the American Medical Association, 291, 1464-1470.

Correspondence Address:
Arthur Barsky, Department of Psychiatry, Brigham and Women's Hospital, 75 Francis St., Boston, MA, US, abarsky@partners.org.

Abstract
Until recently, there was no empirically validated treatment for the hypochondriacal patient's somatic symptoms, belief in the presence of an undiagnosed disease, health-related anxiety, and bodily preoccupation. Using a randomized, usual care control group design, subjects were screened with a self-report hypochondriasis questionnaire and physicians were randomized immediately following the baseline research interview. Subjects were: (1) successive patients attending primary care practices in 2 large, academic medical centers, and (2) volunteers responding to public announcements. Cognitive behavior therapy was administered individually in six 90-minute sessions at weekly intervals. Each session was tightly scripted and devoted to 1 of 5 factors that cause patients to amplify somatic symptoms and misattribute them to serious disease. CBT sessions specifically targeting the cognitive and perceptual mechanisms thought to underlie hypochondriasis, appear to significantly improve a range of hypochondriacal symptoms, beliefs, and attitudes. These effects are evident at 6-month follow-up and persist at 12 months. The findings are compatible with the only other major trial reported to date and expand on it by having a control group available for comparison at long-term follow-up. (PsycINFO Database Record (c) 2005 APA, all rights reserved)