Early Psychological Interventions for Somatic Symptom Disorder and Functional Somatic Syndromes, 2021, Berezowski et al

Full title: Early Psychological Interventions for Somatic Symptom Disorder and Functional Somatic Syndromes
A Systematic Review and Meta-Analysis

Abstract
Objective
Psychological treatments for somatic symptom disorder and functional somatic syndromes (SSD/FSS) achieve moderate effects only, potentially because of the high chronicity in these patients. Therefore, we aimed to evaluate whether early treatment, i.e. treatment in populations at risk or with recent onset, improves outcome.

Methods
We conducted a systematic review and meta-analysis of (cluster)-randomized controlled trials evaluating early psychological interventions in the prevention and treatment of SSD/FSS in adults compared to inactive control conditions, standard care or placebo. Individuals at risk for SSD/FSS, suffering from sub-threshold symptoms or new onsets of SSD/FSS, or presenting with SSD/FSS for the first time were included.

Results
We identified 30 eligible studies, mostly examining pain-related conditions. Interventions were diverse, ranging from bibliotherapy to cognitive behavioral therapy. We found positive effects on depression post-treatment (Hedges’ g = 0.12, 95%-CI: [0.03, 0.2], k = 5) as well as on somatic symptom severity (g = 0.25 [0.096, 0.41], k = 17) and health care utilization (g = 0.31 [0.18, 0.44], k = 3) at follow-up. However, due to high risk of bias, sensitivity to corrections for meta-bias, and missing outcome data, findings should be interpreted cautiously.

Conclusions
Our review shows that targeting SSD/FSS at an early stage represents a conceptual and practical challenge. Readily accessible interventions addressing transsymptomatic processes of SSD/FSS development and consolidation are highly needed. Future studies are needed to evaluate individuals with diverse symptoms, examine symptom history thoroughly, use placebo controls, and report outcomes completely to determine the efficacy of early psychological interventions for SSD/FSS.

Paywall, https://journals.lww.com/psychosoma...ological_Interventions_for_Somatic.98372.aspx

 

Well, if getting a diagnosis of a medical problem takes years (as it so often does) then logically the chances of identifying SSD/FSS ought to be a challenge. The longer that patients can be kept out of the wastebasket the better. But I'm sure that isn't what the researchers wanted to know or to find out. In fact ditching the diagnoses of SSD and FSS altogether would be my preferred option.