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3 - Evidence-based treatment

Published online by Cambridge University Press:  05 August 2011

By
Francis Creed ,
Kurt Kroenke ,
Peter Henningsen ,
Alka Gudi  and
Peter White
Edited by
Francis Creed ,
Peter Henningsen  and
Per Fink
Francis Creed
Affiliation:
University of Manchester
Peter Henningsen
Affiliation:
Technische Universität München
Per Fink
Affiliation:
Aarhus Universitet, Denmark
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Summary

This chapter provides an overview of the current state of evidence regarding treatment of medically unexplained symptoms, somatisation and the functional somatic syndromes. Both primary and secondary care studies have been performed to assess the efficacy of psychological interventions, most commonly cognitive behaviour therapy administered by a mental health professional, or antidepressants, prescribed by the patient's usual doctor. Thirteen trials evaluated cognitive behaviour therapy, five evaluated antidepressants, four the effect of a consultation letter to the general practitioner (GP) and three the training of GPs. The chapter reviews psychological treatments and the use of antidepressants. It uses three systematic reviews to provide an overview of the evidence of efficacy of interventions for functional somatic symptoms. The evidence is stronger for some pharmacological treatments than for psychological treatments partly because of the universal use of placebo tablets and the lack of an attention-placebo in psychological treatment trials.
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Chapter
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Medically Unexplained Symptoms, Somatisation and Bodily Distress
Developing Better Clinical Services
 , pp. 69 - 96
Publisher: Cambridge University Press
Print publication year: 2011

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