Patients with somatization disorder (SD) who are treated using the psychiatric consultation intervention (PCI) may benefit from the addition of cognitive behavioral therapy (CBT) to their regimen. Dr Leslie A. Allen and colleagues recently conducted a randomized controlled trial to determine the outcomes of patients with SD who were treated using a combination of CBT and PCI or treatment with PCI alone. The results were reported in the July issue of Archives of Internal Medicine.
To date, PCI—which consists of a letter to the primary care physician recommending that he or she examine the patient during regularly scheduled appointments while limiting additional diagnostic procedures—is the only evidence-based treatment that was proved to be ef fective in treating SD, according to the authors. They hypothesized that adding 10 sessions of CBT to treatment with PCI would further ameliorate SD symptoms. The authors used CBT that focused on stress management, activity regulation, emotional awareness, cognitive restructuring, and interpersonal communication.
Eighty-four patients who met DSM-IV criteria for SD and had a severity score of 4 or higher on the Clinical Global Scale Impression for SD completed the study. Forty-three of them received treatment with CBT and PCI and 41 were treated with just PCI.
The group using CBT and PCI demonstrated significantly greater improvement over the PCI group at the 3-month (P < .001), 9-month (P < .001), and 15-month (P = .004) assessment. The authors emphasized the need for more studies on treatment with CBT for SD, as well as the need to determine whether treatment benefits with CBT extend beyond 1 year.