Changes after multicomponent group-based treatment in patients with medically unexplained physical symptoms 2022, Polakovska et al

[Sly Saint]

ABSTRACT
Psychological treatments for patients with medically unexplained physical symptoms (MUPS) reduce somatic symptom severity only moderately. However, patients may profit from changes other than that of symptom reduction. The aim of the present study was to capture the changes that patients with MUPS experience after a multicomponent group-based treatment. Semistructured interviews with 30 patients with MUPS were undertaken after the treatment. Thematic analysis was used to identify the changes the patients reported.

The changes included developing a different view of their somatic symptoms, learning how to fulfill their needs, modifying their lifestyle, and becoming open to painful experiences. The patients also noted changes in their somatic symptoms and their quality of life. Multicomponent treatment helps patients with MUPS achieve a variety of changes that reach beyond physical symptoms reduction. Patients’ symptoms often worsen after a return to normal life, which calls for continual care.

https://www.tandfonline.com/doi/abs/10.1080/09515070.2022.2142200?journalCode=ccpq20

 

[Trish]

I haven't read the paper, just the abstract. Does that final sentence imply that the improvements patients report immediately after a series of group sessions aren't sustained?

I think the conclusion from that seems obvious. The temporary apparent effect on symptoms is an illusion, more about feeling supported and wanting to please the therapist, not any real effect on symptoms.

 

[rvallee]

The changes included developing a different view of their somatic symptoms, learning how to fulfill their needs, modifying their lifestyle, and becoming open to painful experiences

Ah, so they're doing the thing where they put words into patients' mouths and pretend the patients said those things, rather than them limiting discussion to those things.

Exactly like a focus group on tomato sauce that declares tomato sauce 3 is the group's favorite sauce of all time, because it's the one they preferred out a group of very meh sauces and would never actually be on the list of favorite sauces if it weren't restricted to a pre-selection.

We know this is how it works. We've seen the same thing with the Priority setting group and this is usually the case in all issues relating to chronic illness: so-called psychosocial priorities are not the patients' priorities, never have been, never will be. Because we understand causality and that it's best to solve all downstream impacts by solving the cause, and that reattributing downstream impacts as the cause is a very well-tested method to fail.

So in many ways, literally worse than market research focus groups. Because in market research focus groups, getting the answers you want instead of the real ones is a great way to go bankrupt. Or at least to be out of a job, because most companies don't want comforting lies, they want real data. But of course when funding is there regardless of outcomes, you get a very different, and far lower quality, process than the people trying to figure out which food people will buy, not just express some willingness or whatever but will actually take into their hands, put in their cart and pay for at the grocery store. Real, validated, objective outcomes.

If only medical research managed to care about their work as much as market research professionals running focus groups selling food and other products.

 

[Sean]

Psychological treatments for patients with medically unexplained physical symptoms (MUPS) reduce somatic symptom severity only moderately.

'...reduce reporting of somatic symptom severity...'

Patients’ symptoms often worsen after a return to normal life, which calls for continual care.

Don't you love how they completely ignore the obvious explanation that biasing reporting is only a short-term effect, with no meaningful clinical benefit at all?

 

[DokaGirl]

It stands to reason that if a disease is debilitating enough to cause isolation, e.g. being homebound, getting a chance to interact in a "multicomponent group-based treatment", may temporarily improve QOL.

Perhaps being in such a study may validate the suffering, instead of the frequent gaslighting people with "MUPS" experience. This might cause participants to "feel better".

Sharing their experiences, having someone listen to them, learning that others have similar illnesses and situations, may provide a short-lived boost to the participants.

It also stands to reason, that going back to one's isolation, and reduction in engagement with others with like situations could worsen QOL.

 

[NelliePledge]

Yes I agree There are some potential knock on benefits from the validation of taking part in something like this. As well as giving a connection to others in the same boat from the actual programme. Validation can come from the ability to talk to family friends and if relevant colleagues about it, having a referral officially recognising there is actually something there you need help with. May result in getting more understanding from the wider circle possibly more support. Nothing to do with the content of the programme