Somatization disorder, a syndrome characterized by multiple medically unexplained physical symptoms, often results in substantial functional impairment and extensive medical treatment. Although preliminary research has shown cognitive behavior therapy (CBT) to be moderately effective with somatization disorder patients, no intervention has well-established and long-term efficacy for this disorder. Recent theory and initial clinical work suggests somatizers may benefit from a combined individual and group treatment that integrates emotion-centered strategies into the CBT framework. This is an exploratory/developmental grant proposal to collect preliminary data on the efficacy of this multi-dimensional treatment, Cognitive-Affective Behavior Therapy (CABT), for somatization disorder. In Study 1,70 patients diagnosed with somatization disorder will participate in a randomized, controlled pilot study assessing the efficacy of CABT. Control participants will receive standard medical care, augmented by a psychiatric consultation. Therapeutic gains will be assessed over the year following treatment in several domains: somatic symptomatology, functional impairment, and health care costs. The findings from this pilot study will be used to estimate intervention parameters, such as effect size, attrition rate, and response rate, and to perform power analyses for a future full-scale randomized, controlled trial examining the efficacy of CABT. Study 2 is proposed because research on somatization disorder is limited by its measurement of outcome. No current measure adequately assesses the severity of somatization symptomatology. For Study 2, preliminary data will be collected on the psychometric properties of a clinician-administered scale, the Inventory of Somatoform Symptoms (ISS). On three separate occasions, the 70 participants from Study 1 as well as a comparison group of 25 non-somatizing psychiatric patients will be evaluated with the ISS to determine the feasibility of its use and to collect initial reliability and validity data. If these preliminary data suggest the ISS's reliability and validity are adequate, additional testing of the instrument will be conducted in the future.
| Allen, Lesley A; Woolfolk, Robert L; Escobar, Javier I et al. (2006) Cognitive-behavioral therapy for somatization disorder: a randomized controlled trial. Arch Intern Med 166:1512-8 |
