Treatment effects of multimodal inpatient psychotherapy for post-COVID patients: First results from a non-randomized, controlled study, 2026, Koller+

[SNT Gatchaman]

Treatment effects of multimodal inpatient psychotherapy for post-COVID patients: First results from a non-randomized, controlled study

Spoiler: Authors

Koller; Hanc; Herold; Kastel-Hoffmann; Morawa; Erim

BACKGROUND
Evidence-based treatment options for post-COVID syndrome remain limited. This study evaluated the effectiveness of a five-week inpatient psychosomatic treatment program for post-COVID patients.

METHODS
In this prospective non-randomized controlled trial, patients with confirmed post-COVID syndrome were recruited from a specialized Post-COVID Center and allocated, based on treatment preference, either to a five-week multimodal inpatient psychosomatic program (intervention group) or to treatment-as-usual without inpatient psychosomatic care (control group). Outcomes were assessed at baseline (T0) and after five weeks (T1). Measures included post-COVID symptom severity (PCS score), fatigue (FSS), depressive symptoms (PHQ-9), anxiety (GAD-7), health-related quality of life (SF-36), and illness-related coping competence (PCQ-2). Group differences over time were analyzed using repeated-measures analysis of covariance, controlling for the T0-T1 interval.

RESULTS
The present study included 71 patients in the intervention group and 49 in the control group, with no baseline group differences in outcomes. Compared with controls, the intervention group showed significantly larger improvements in depressive symptoms (p = .042, η2ₚ = 0.035), mental health-related quality of life (p = .014, η2ₚ = 0.064), social functioning (p = .005, η2ₚ = 0.084), and overall patient competence (p = .018, η2ₚ = 0.048). No group-by-time interaction effects were found for post-COVID symptom severity, fatigue, anxiety, or physical health-related quality of life. Within the intervention group, significant but small improvements were found for fatigue (p = .029, d = 0.275) and anxiety (p = .008, d = 0.324), alongside improvements in psychological outcomes.

DISCUSSION
A structured inpatient psychosomatic program can improve psychological well-being and coping competence in post-COVID patients with mental health comorbidities. While effects on physical symptoms were limited, strengthened coping resources may facilitate longer-term stabilization.

TRIAL REGISTRATION
German Clinical Trial Register (DRKS), retrospectively registered: 15.02.2024; DRKS-ID: DRKS00033562.

HIGHLIGHTS
• Patients coping competence increased significantly following treatment.

• Inpatient psychosomatic care reduces psychological burden of post-COVID patients.

• Depressive symptoms decreased more with inpatient treatment than with usual care.

• Mental health–related quality of life improved more in the intervention group.

• Fatigue showed pre–post improvement in the intervention group.

Web | DOI | PDF | Journal of Psychosomatic Research | Open Access

 

[Peter T]

Self selection for which trial arm individual participants were assigned to seems to invite selection bias.

 

[Sean]

Outcomes were assessed at baseline (T0) and after five weeks (T1).​

On subjective self-report outcomes, after just five weeks treatment for a condition known to last years (and potentially a lot longer), via an inpatient program designed to get patients to report better scores on subjective self-report measures.

 

[Utsikt]

The in-group differences for the treatment group as far to small to be of any value in real life.

The authors do not acknowledge the issues caused by using subjective outcomes without blinding.

Yet another case of researchers living in a make-believe world.

 

[rvallee]

Evidence-based treatment options for post-COVID syndrome remain limited. This study evaluated the effectiveness of a five-week inpatient psychosomatic treatment program for post-COVID patients.

Treatment options are limited, so they 'tested' the current option that has been standard from day 1 and to which hundreds of thousands have been subjected, hence the widely known fact that there are no treatments. Yup, makes perfect sense when you don't think about it. Especially when they find it's not effective and recommend it anyway.

Also it's odd to frame this as "first results", because easily 100+ such trials have been done already, so it only leaves the idea that they will publish more results, which is not needed and a complete waste of time, resources and lives.

But, hey, they add a few citations to their academic index, as long as their stonks go up who cares, right? Stonks go up, lives go down. Can't explain that.

 

[Jonathan Edwards]

To actually announce that your study is non-randomised, as well as omitting that it is non-blinded and pretending it is effectively controlled seems like scraping the floor of the cellar under the barrel.

 

[SNT Gatchaman]

They needed to adjust the hyphen.

non-randomized controlled trial → non randomized-controlled-trial

Also it's a prospective study but retrospectively registered.

For the intervention group, an indication for inpatient psychosomatic treatment was required, such as (5) a diagnosed mental disorder according to ICD-10, significant limitations in the ability to manage daily life (e.g., maintaining daily structure), and/or subjective stress so severe that quality of life and everyday resilience were considerably reduced. The inclusion criterion (5) was assessed and confirmed by physicians in advanced or completed specialized training in psychosomatic medicine and psychologists in advanced or completed training in clinical psychotherapy during a psychosomatic consultation at the Post-COVID Center; in addition, (6) patients had to opt for inpatient treatment. Eligibility for the control group required (7) a decision against the inpatient treatment with (8) clinically relevant depressive symptoms (PHQ-9 ≥ 10). The PHQ-9 was also assessed during the initial consultation at the Post-COVID Center.

Exclusion criteria for the intervention and the control group included (1) severe physical impairment (predominantly bedridden patients), (2) a primary diagnosis of substance abuse (ICD-10 F10-F19), schizophrenia or psychosis (F20-F29), or organic psychiatric disorders (F00-F05), as well as (3) acute suicidality. Additionally, control group patients were excluded if they (4) made use of post-COVID-specific inpatient psychotherapeutic treatment or psychosomatic rehabilitation during the 5week assessment period.

 

[Jonathan Edwards]

Also it's a prospective study but retrospectively registered.

That sounds a bit like discovering at coffee time that you put your boxer shorts on the wrong way round when you got up.