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Acceptance and Commitment group Therapy for patients with multiple functional somatic syndromes: a three-armed trial comparing ACT in a brief and extended version with enhanced care

Published online by Cambridge University Press:  26 June 2018

Heidi Frølund Pedersen Open the ORCID record for Heidi Frølund Pedersen [Opens in a new window] ,
Johanne L. Agger ,
Lisbeth Frostholm ,
Jens S. Jensen ,
Eva Ørnbøl ,
Per Fink  and
Andreas Schröder
Heidi Frølund Pedersen*
Affiliation:
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C., Denmark
Johanne L. Agger
Affiliation:
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C., Denmark
Lisbeth Frostholm
Affiliation:
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C., Denmark
Jens S. Jensen
Affiliation:
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C., Denmark
Eva Ørnbøl
Affiliation:
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C., Denmark
Per Fink
Affiliation:
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C., Denmark
Andreas Schröder
Affiliation:
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C., Denmark
*
Author for correspondence: Heidi Frølund Pedersen, E-mail: [email protected]
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Abstract

Background

Psychological treatment for functional somatic syndromes (FSS) has been found moderately effective. Information on how much treatment is needed to obtain improvement is sparse. We assessed the efficacy of a brief and extended version of group-based Acceptance and Commitment Therapy (ACT) v. enhanced care (EC) for patients with multiple FSS operationalised as Bodily Distress Syndrome multi-organ type.

Methods

In a randomised controlled three-armed trial, consecutively referred patients aged 20–50 with multiple FSS were randomly assigned to either (1) EC; (2) Brief ACT: EC plus 1-day workshop and one individual consultation; or (3) Extended ACT: EC plus nine 3-h group-based sessions. Primary outcome was patient-rated overall health improvement on the five-point clinical global improvement scale 14 months after randomisation. A proportional odds model was used for the analyses.

Results

A total of 180 patients were randomised; 60 to EC, 61 to Brief ACT, and 59 to Extended ACT. Improvement on the primary outcome after Extended ACT was significantly greater than after EC with an unadjusted OR of 2.9 [95% CI (1.4–6.2), p = 0.006]. No significant differences were found between Brief ACT and EC. Of the 18 secondary outcomes, the only significant difference found was for physical functioning in the comparison of Extended ACT with EC.

Conclusions

Patients rated their overall health status as more improved after Extensive ACT than after EC; however, clinically relevant secondary outcome measures did not support this finding. Discrepancies between primary and secondary outcomes in this trial are discussed.

Keywords

Acceptance and Commitment Therapyfunctional somatic syndromespsychological treatmentRCTsomatoform disorders
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 6 , April 2019 , pp. 1005 - 1014
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

*

These authors have contributed equally to this paper.

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