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Titolo:
Cognitive-behavioral therapy for somatization and symptom syndromes: A critical review of controlled clinical trials
Autore:
Kroenke, K; Swindle, R;
Indirizzi:
Indiana Univ, Sch Med, Regenstrief Inst, Indianapolis, IN USA Indiana Univ Indianapolis IN USA Regenstrief Inst, Indianapolis, IN USA Indiana Univ, Sch Med, Dept Med, Indianapolis, IN USA Indiana Univ Indianapolis IN USA Sch Med, Dept Med, Indianapolis, IN USA Indiana Univ, Sch Med, Richard Roudebush Vet Adm Hosp, Hlth Serv Res & DevDiv, Indianapolis, IN USA Indiana Univ Indianapolis IN USA Serv Res & DevDiv, Indianapolis, IN USA
Titolo Testata:
PSYCHOTHERAPY AND PSYCHOSOMATICS
fascicolo: 4, volume: 69, anno: 2000,
pagine: 205 - 215
SICI:
0033-3190(200007/08)69:4<205:CTFSAS>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOMIZED CONTROLLED TRIAL; CHRONIC FATIGUE SYNDROME; LOW-BACK-PAIN; IRRITABLE-BOWEL-SYNDROME; NONCARDIAC CHEST PAIN; UNEXPLAINED PHYSICAL SYMPTOMS; PRIMARY-CARE; PSYCHOLOGICAL TREATMENTS; PSYCHIATRIC-CONSULTATION; DIFFICULT PATIENT;
Keywords:
cognitive-behavioral therapy; cognitive therapy; somatization; somatoform disorders; psychophysiologic disorders;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Kroenke, K Regenstrief Inst Hlth Care, RG-6,1050 Wishard Blvd, Indianapolis, IN 46202USA Regenstrief Inst Hlth Care RG-6,1050 Wishard Blvd Indianapolis IN USA 46202
Citazione:
K. Kroenke e R. Swindle, "Cognitive-behavioral therapy for somatization and symptom syndromes: A critical review of controlled clinical trials", PSYCHOTH PS, 69(4), 2000, pp. 205-215

Abstract

Objective: Few treatments for somatization have been proven effective. In the past decade, however, clinical trials of cognitive-behavioral therapy (CBT) have been promising. Our aim was to critically review and synthesize the evidence from these trials. Methods: A search of the Medline database from 1966 through July 1999 was conducted to identify controlled trials designed to evaluate the efficacy of CBT in patients with somatization or symptom syndromes. Results: A total of 31 controlled trials (29 randomized and 2 nonrandomized) were identified. Twenty-five studies targeted a specific syndrome (e.g. chronic fatigue, irritable bowel, pain) while 6 focused on moregeneral somatization or hypochondriasis. Primary outcome assessment included physical symptoms, psychological distress and functional status in 28, 26 and 19 studies, respectively. Physical symptoms appeared the most responsive: CBT-treated patients improved more than control subjects in 71% of thestudies and showed possibly greater improvement (i.e., a trend) in another11% of the studies. A definite or possible advantage of CBT for reducing psychological distress was demonstrated in only 38 and 8% of studies, and for improving functional status in 47 and 26%. Group therapy and interventions as brief as 5 sessions proved efficacious. Benefits were sustained for upto 12 months. Conclusion: CBT can be an effective treatment for patients with somatization or symptom syndromes. Benefits can occur whether or not psychological distress is ameliorated. Since chronic symptoms are exceptionally common and most studies were conducted in referral populations, the optimal sequencing of CBT in treating primary care patients and the identification of those most likely to accept and respond to therapy should be furtherevaluated. Copyright (C) 2000 S. Karger AG. Basel.

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Documento generato il 02/04/20 alle ore 02:47:55