Question: In adults with somatoform disorders and medically unexplained physical symptoms (MUPS), how effective are non-pharmacological interventions, compared to any other treatment, in improving patient outcomes?

Answer:

Plain language summary

Limited evidence suggests that some psychological therapies such as CBT, mindfulness and psychotherapy can improve patient outcomes in patients with somatoform disorders with or without medically unexplained physical symptoms. However, more high quality research is needed in this area to adequately assess the effectiveness of these interventions.

Clinical and research implications

There is a reasonable amount of low to moderate quality evidence from two systematic reviews that psychological therapies including CBT, mindfulness and psychotherapy can reduce somatic symptoms and patient withdrawal and improve treatment response, quality of life and functional impairment compared to usual care in patients with somatoform disorders with or without medically unexplained physical symptoms. There is also some evidence from one small, low quality RCT that brief group psychoeducation can improve psychosocial functioning and patients' opinions of their condition compared to follow-up clinic visits in patients with non-epileptic psychogenic events admitted to an epilepsy monitoring clinic.

Further research is needed comparing different psychological therapies and mechanisms of change, in participants of different ages, and using blinded outcome assessment. Future RCTs should also be multi-centre with longer follow-up periods.

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