title: Mindfulness therapy for somatization disorder and functional somatic syndromes: analysis of economic consequences alongside a randomized trial.
abstract: OBJECTIVE
  The objective of the present study is to estimate the economic consequences of somatization disorder and functional somatic syndromes such as fibromyalgia and chronic fatigue syndrome, defined as bodily distress syndrome (BDS), when mindfulness therapy is compared with enhanced treatment as usual.
  
  
  METHODS
  A total of 119 BDS patients were randomized to mindfulness therapy or enhanced treatment as usual and compared with 5950 matched controls. Register data were analyzed from 10years before their inclusion to 15-month follow-up. The main outcome measures were disability pension at the 15-month follow-up and a reduction in total health care costs. Unemployment and sickness benefit prior to inclusion were tested as possible risk factors.
  
  
  RESULTS
  At 15-month follow-up, 25% from the mindfulness therapy group received disability pension compared with 45% from the specialized treatment group (p=.025). The total health care utilization was reduced over time in both groups from the year before inclusion (mean $5325, median $2971) to the year after inclusion (mean $3644, median $1593) (p=.0001). This overall decline was seen in spite of elevated costs due to assessment and mindfulness therapy or enhanced treatment as usual. The BDS patients accumulated significantly more weeks of unemployment and sickness benefit 5 and 10years before inclusion (p<.0001) than the population controls.
  
  
  CONCLUSIONS
  Mindfulness therapy may prevent disability pension and it may have a potential to significantly reduce societal costs and increase the effectiveness of care. Accumulated weeks of unemployment and sickness benefit are possible risk factors for BDS.
authors.affiliation: The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark. lonefjor@rm.dk
authors.forename: Lone Overby
authors.initials: LO
authors.lastname: Fjorback
authors.forename: Tina
authors.initials: T
authors.lastname: Carstensen
authors.forename: Mikkel
authors.initials: M
authors.lastname: Arendt
authors.forename: Eva
authors.initials: E
authors.lastname: Ornbøl
authors.forename: Harald
authors.initials: H
authors.lastname: Walach
authors.forename: Emma
authors.initials: E
authors.lastname: Rehfeld
authors.forename: Per
authors.initials: P
authors.lastname: Fink
mesh_terms: D000328:Adult; D001364:Awareness; D015928:Cognitive Behavioral Therapy / Q000191:economics* / Q000379:methods*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003718:Denmark; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D019122:Meditation / Q000379:methods* / Q000523:psychology*; D008875:Middle Aged; D010415:Pensions; D011614:Psychotherapy, Brief / Q000191:economics* / Q000379:methods*; D012064:Relaxation Therapy / Q000191:economics* / Q000379:methods* / Q000523:psychology; D012943:Social Security / Q000191:economics; D013001:Somatoform Disorders / Q000175:diagnosis / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D013577:Syndrome; D016896:Treatment Outcome