title: Psychophysiologic treatment for patients with medically unexplained symptoms: a randomized controlled trial.
abstract: BACKGROUND
  Patients presenting with medically unexplained physical symptoms (MUPS) typically present with significant distress and marked impairment in functioning and pose a unique challenge to health care providers. The purpose of this study was to examine the efficacy of a psychophysiological treatment (PT) for MUPS.
  
  
  METHODS
  Thirty-eight participants meeting criteria for subthreshold somatization disorder (abridged somatization) were randomly assigned to one of two conditions: (1) standard medical care augmented by a psychiatric consultation intervention (wait-list) or (2) a 10-session, manualized, individually-administered PT added to the psychiatric consultation intervention. Assessments were conducted at baseline, at midpoint (after four sessions), and after completing the last session. The primary outcome measure was the severity scale of the Clinical Global Impression Scale anchored for Somatic Symptoms (CGI-SD). Secondary outcome measures were responder status as determined by clinical ratings, self-report measures of mental and physical functioning.
  
  
  RESULTS
  At the end of the trial, the severity (and frequency) of physical symptoms improved significantly more (p<0.05) in the intervention group. The average improvement in the CGI-SD was 0.80 points greater in the intervention group than in the wait-list group. PT was also associated with greater improvements in self-reported functioning and depressive symptomatology. The effect sizes at the final assessment point indicate that this intervention had a robust effect on complex somatic symptom presentations.
  
  
  CONCLUSIONS
  For patients with high levels of MUPS (abridged somatization), PT produces significant improvements in symptoms and functional status.
authors.affiliation: Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA. karavima@umdnj.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Katsamanis
authors.forename: Paul M
authors.initials: PM
authors.lastname: Lehrer
authors.forename: Javier I
authors.initials: JI
authors.lastname: Escobar
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gara
authors.forename: Anupama
authors.initials: A
authors.lastname: Kotay
authors.forename: Regina
authors.initials: R
authors.lastname: Liu
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology; D005260:Female; D006801:Humans; D008297:Male; D011603:Psychophysiology / Q000379:methods; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome