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Intensive Multidisciplinary Treatment of Severe Somatoform Disorder: A Prospective Evaluation

Houtveen, Jan H. PhD*†; van Broeckhuysen-Kloth, Saskia PhD*; Lintmeijer, Lotte L. MSc*; Bühring, Martina E.F. MD, PhD*; Geenen, Rinie PhD

Journal of Nervous & Mental Disease: February 2015 - Volume 203 - Issue 2 - p 141–148
doi: 10.1097/NMD.0000000000000250
Original Articles

Abstract: Chronic severe somatoform disorder (SFD) is resistant to treatment. In a prospective observational study, we evaluated an intensive multidisciplinary treatment focusing on body-related mentalization and acceptance. Patients included in the study were 183 (146 women, 37 men) of 311 eligible patients with chronic severe SFD, referred consecutively to a specialized tertiary care center between 2002 and 2009. Primary outcome measures were somatic symptoms (SCL-90) and health-related quality of life (EuroQol 5-Dimensional [EQ-5D]). These measures were assessed four times before treatment (on intake, twice during an observation period, at start of treatment) and four times after treatment (during follow-up for 2 years). Multilevel analysis was used to separate effects of time (maturation) and treatment. Results revealed significant improvements in SCL-90 somatic symptoms (d = 0.51), EQ-5D index (d = 0.27), and EQ visual analogue scale (d = 0.56). Significant reductions were also observed in SCL-90 anxiety, depression, and overall psychopathology as well as in medical consumption associated with psychiatric illness (Trimbos/iMTA Questionnaire for Costs Associated With Psychiatric Illness). Large interindividual differences were found in treatment outcome. The long-term improvement seen in many patients suggests that intensive multidisciplinary tertiary care treatment is a useful approach to chronic severe SFD.

*Altrecht Psychosomatic Medicine Eikenboom, Zeist; †University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen; and ‡Department of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands.

Send reprint requests to Jan H. Houtveen, PhD, Altrecht Psychosomatic Medicine Eikenboom, Voortgang 6, 3705 WD Zeist, the Netherlands. E-mail: j.h.houtveen@umcg.nl.

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