title: Effectiveness of group cognitive behavioral therapy for somatoform pain disorder patients in Japan: A preliminary non-case-control study.
abstract: OBJECTIVE
  Somatoform pain disorder is associated with psychosocial dysfunction, and psychotherapies, such as cognitive behavioral therapy (CBT), are thought to provide useful interventions to address such dysfunction as well as the pain itself. However, little is known about whether CBT for somatoform pain disorder is effective, including the long-term course of the illness, in non-Western populations. We therefore tailored such a program based on an existing CBT protocol and examined its effectiveness in Japan.
  
  
  METHODS
  Thirty-four Japanese participants (22 women; mean age = 52.5 years) enrolled in a weekly 12-session group treatment, with 32 completing both wait-list and treatment conditions. The primary outcome measure was pain intensity. Secondary outcome measures included pain characteristics, as measured by pain catastrophizing and psychometric evaluations, including depression, anxiety, and quality of life. The patients were followed up for 12 months after treatment.
  
  
  RESULTS
  We found that pain intensity, anxiety, depressive symptoms, and social functioning all significantly improved after treatment compared with the wait-list period, and the improvements in pain intensity, depressive symptoms, and social functioning were sustained at 12 months following the completion of CBT. There were strong positive correlations (P < 0.01) among pre- and post-treatment changes in the affective dimension of pain, depression, anxiety, and pain catastrophizing.
  
  
  CONCLUSIONS
  These results show that the present CBT program was effective for Japanese patients with somatoform pain disorder and that gains were maintained over the long term. More work is needed to further clarify the effects of CBT interventions on somatoform symptoms, particularly in Japan.
authors.affiliation: Department of Psychiatry and Neurosciences, Division of Frontier Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yoshino
authors.affiliation: Department of Psychiatry and Neurosciences, Division of Frontier Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Department of Dental Anesthesiology, Hiroshima University, Hiroshima, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Doi
authors.affiliation: National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Horikoshi
authors.affiliation: Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Oshita
authors.affiliation: Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Nakamura
authors.affiliation: Bio-Environmental Adaptation Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Otsuru
authors.affiliation: Department of Psychology, Otemon Gakuin University, Osaka, Japan.
authors.forename: Shinpei
authors.initials: S
authors.lastname: Yoshimura
authors.affiliation: Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Psychiatry and Neurosciences, Division of Frontier Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Takagaki
authors.affiliation: Department of Psychiatry and Neurosciences, Division of Frontier Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Ran
authors.initials: R
authors.lastname: Jinnin
authors.affiliation: Department of Psychiatry and Neurosciences, Division of Frontier Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Hidehisa
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawamoto
authors.affiliation: Department of Psychiatry and Neurosciences, Division of Frontier Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yamawaki
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D058443:Catastrophization / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D011615:Psychotherapy, Group / Q000379:methods*; D013001:Somatoform Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
keywords: chronic pain; cognitive behavioral therapy; pain catastrophizing; somatic symptom disorder; somatoform pain disorder