Cognitive Behavior Therapy for Medically Unexplained Symptoms: A Systematic Review and Meta-analysis of Published Controlled Trials
Language: 
English
Short Title: 
Cognitive Behavior Therapy for Medically Unexplained Symptoms
Abstract: 

Medically unexplained symptoms (MUS) commonly present across the board in medical specialties and are often challenging to treat. Our objective was to assess the efficacy for cognitive-behavior therapy (CBT) in MUS. Electronic search of databases was carried out for published controlled trials in English language peer-reviewed journals from inception till August 2016. Effect sizes for the trials were computed using standardized mean difference, and I(2) test was used to assess sample heterogeneity. Pooled mean effect sizes were derived using a random-effects model. Critical appraisal of studies was done using the Cochrane risk of bias assessment tool. A total of 11 trials involving 1235 subjects were included in the study. Ten trials used standard CBT techniques while one studied the efficacy of mindfulness-based CBT technique. The control arms were treatment as usual in five trials, augmented care in four and waitlisted controls in two trials. The pooled mean effect size for CBT was 0.388 (range 0.055-0.806, 95% confidence intervals 0.316-0.461). The I(2) value was 0 using a random effects model indicating low heterogeneity among studies. Risk of bias was noted in many included studies. Egger plot intercept indicated potential publication bias. CBT was superior to the waiting list, treatment as usual or enhanced usual care with moderate effect sizes in the treatment of MUS. These findings are impacted by the limited number of studies in this area and questionable methodological rigor of included studies.

Author(s): 
Menon, Vikas
Rajan, Tess Maria
Kuppili, Pooja Patnaik
Sarkar, Siddharth
Item Type: 
Journal Article
Publication Title: 
Indian Journal of Psychological Medicine
Journal Abbreviation: 
Indian J Psychol Med
Publication Date: 
2017-08
Publication Year: 
2017
Pages: 
399-406
Volume: 
39
Issue: 
4
ISSN: 
0253-7176
DOI: 
10.4103/IJPSYM.IJPSYM_17_17
Library Catalog: 
PubMed
Extra: 
PMID: 28852229 PMCID: PMC5559983

Turabian/Chicago Citation

Vikas Menon, Tess Maria Rajan, Pooja Patnaik Kuppili and Siddharth Sarkar. 2017-08. "Cognitive Behavior Therapy for Medically Unexplained Symptoms: A Systematic Review and Meta-analysis of Published Controlled Trials." Indian Journal of Psychological Medicine 39: 4: 399-406. 10.4103/IJPSYM.IJPSYM_17_17.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.4103/IJPSYM.IJPSYM_17_17 | issn = 0253-7176 | volume = 39 | pages = 399-406 | last = Menon | first = Vikas | coauthors = Rajan, Tess Maria, Kuppili, Pooja Patnaik, Sarkar, Siddharth | title = Cognitive Behavior Therapy for Medically Unexplained Symptoms: A Systematic Review and Meta-analysis of Published Controlled Trials | journal = Indian Journal of Psychological Medicine | date = 2017-08 | pmid = | pmc = }} </ref>