Review Predictors of Treatment Success of Psychotherapy in Functional Disorders: A Systematic Review of the Literature 2025 Rometsch et al

Andy

Retired committee member
ABSTRACT

Objective
Functional disorders (FDs) benefit from psychotherapy. However, the determinants predicting their efficacy remain largely unexplored.

Methods
A systematic literature review was conducted. PubMed, Web of Science, Embase, Cochrane collaboration and grey literature were screened from inception to November 2024. Randomized controlled trials on predictors of success of psychotherapy for FDs (e.g., somatoform disorders, irritable bowel syndrome [IBS], chronic fatigue syndrome/myalgic encephalomyelitis [CFS/ME], fibromyalgia [FM]) in adults (i.e., ≥ 18 years of age) were included. The review yielded 24 eligible studies and included 3382 participants. A standardized quality assessment via ROB-2 Tool was performed. PRISMA guidelines were followed.

Results
Most studies applied CBT-based interventions (n = 19), mainly face-to-face, with some internet-based (n = 5), while fewer used emotional-based (n = 4), mindfulness-based (n = 3), psychodynamic (n = 1) or operant behavioural therapy (n = 1). The primary factors identified as predictive of treatment success in FM and somatization were the intensity of experienced pain. Moreover, the presence of mental disorders, i.e., depression and anxiety disorders, emerged as predictors for a range of disorders including FM, IBS, somatization disorder, hypochondriasis, medically unexplained symptoms and dissociative seizures. Symptom severity was recognized as a predictor across various FDs with findings indicated that severe severity could predict treatment outcomes.

Conclusion
The body of research concerning predictors of treatment success in the context of FDs can help clinicians identifying appropriate psychotherapy trajectories.

Funding: This work was supported by European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska Curie grant agreement No. 956673.

Open access
 
The quality of the studies was independently assessed by CR and FM using ROB2 Tool revealing a low risk of bias, ensuring a high level of confidence in the integrity and reliability of the findings, which resulted throughout in a low judgement besides some concerns regarding one study (Vallejo et al. 2015)
I believe all studies were unblinded and most used subjective outcomes. It’s impossible to take this review seriously based in their assessment of bias.
 
I believe all studies were unblinded and most used subjective outcomes. It’s impossible to take this review seriously based in their assessment of bias.
It's all the lowest possible level of quality and the highest possible level of bias and they call it high quality and low bias. How is this entire industry supposed to be taken seriously given this?

And as tradition, all this does is describe what's being used, without any concern or effort to assess anything beyond it.

Plus, how the hell is the memory of Marie Curie served when her legacy funds BS like this?!
 
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