Cognitive behavioural therapy reduced distress and doctor visits in patients with medically unexplained symptoms

Abstract

Question: In patients with medically unexplained symptoms and repeated clinic visits, is cognitive behavioural therapy (CBT) more effective than standard care in reducing symptoms, visits, and distress? Design 3 month randomised (allocation concealed*), blinded (2 outcome assessors)*, controlled trial. Setting: A primary care clinic in a hospital in Colombo, Sri Lanka. Patients. 68 patients who were 16–65 years of age (mean age 38 y, 71% women) and had presented repeatedly at the primary care clinic in the previous 6 months (mean 14 visits/y) with ≥5 medically unexplainable symptoms (distinctive subjective sensation or personal observation in relation to the body which the patient described as abnormal). Exclusion criteria were the presence of such organic psychiatric disorders as dementia, alcohol dependence, psychosis, or active suicidal thoughts; or current receipt of psychiatric treatment. Follow up was 66% at 3 months; all patients were included in the intention to treat analysis.