Table DS1 Characteristics of included studies

Transcription

1 Koelen et al. Effectiveness of psychotherapy for severe somatoform disorder: meta-analysis. Br J Psychiatry doi: /bjp.bp Table DS1 Characteristics of included studies Study N a Diagnosis Outcome measure Allen et al. (2001) (10) SD (DSM-IV-TR) SSD/SSS/ Allen et al. (2006) 8 43 (43) vs. 41 (41) SD (DSM-IV-TR) SSD/SSS/ Treatment conditions Ataoglu et al. (2003) (15) CD (DSM-IV) HRSA 1. PAT 2. Medication RCT MQ e Treatment setting Treatment modality 1. CBT No Out-patient /Systemic 1. CBT/PCI Very good Out-patient /Systemic 2. PCI Bleichhardt et al. 107 (89) (2004) 45 vs. 84 (68) Dongfen & Shizong 60 (60) (1999) 41 vs. 60 (60) SSI-8 SFD (ICD-10) SOMS/SCL- 90/HADS/ EuroQol/ FLZM HRSA/ HRSD Hiller et al. (2003) (172) SFD (ICD-10)/SSI-8 SOMS/BDI/CABA H/DAQ 1. CBT/SM b 2. CBT/Relaxation b 1. CBT/Acupuncture b 2. CBT b 1. CBT 2. Waiting list No /Outpatient f /Group /Group Junkert Tress et al. (2001) (23) SFD (ICD-10) SCL-90/IS/ GAF Leichsenring et al. 13 (13) SFD (ICD-10) SCL-90/ (2008) 39 IIP Moene et al. (2002) (24) SD/CD (DSM-III-R) SCL-90/ vs. 23 ICIDH (21) Moene et al. (2003) (20) SD/CD (DSM-III-R) SCL-90/ ICIDH 1. PDT No Very Out-patient 1. PDT No Very Out-patient 1. TAU/Hypnosis 2. TAU 1. Hypnosis 2. Waiting list good /Group Adequate Out-patient Nanke & Rief (2003) 9 25 (25) vs. 25 (25) SSI-8 CABAH/ BIF 1. CBT/Biofeedback b,c 2. CBT/Relaxation b,c Nickel et al. (2006) (64) vs. 64 (64) Sattel et al. (2012) (107) vs. 104 SFD (DSM-IV-TR) MSFD/PD (ICD-10) SCL-90/ STAXI PHQ/ 1. TAU/BEG 2. TAU/GYM 1. PDT 2. EMC good Out-patient /Group

2 (104) Schneider & Rief (2007) (298) PD (ICD-10) ASF/ FESV Tschuschke et al. 54 (50) USD/SD/SFAD (ICD- SCL-90/ (2007) 7 10) GAF/IS Zaby et al. (2008) (22) SFD (DSM-IV-TR) SOMS/HADS/ vs. 20 SF-12 (20) 1. TAU d No Exceptionally /Group 1. PDT No Very Out-patient Group 1. CBT 2. Relaxation 3. Waiting list Out-patient Group CD=conversion disorder; MSFD=multisomatoform disorder; PD=pain disorder; SD=somatisation disorder; SFAD=somatoform autonomic dysfunction; SFD=somatoform disorder; SSI-8=somatic symptom index; USD=undifferentiated somatisation disorder; ASF=Aachener Selbstwirksamkeitsfragebogen; BDI=Beck Depression Inventory; BIF=Biofeedback questionnaire; CABAH=Cognitions About Body and Health questionnaire; DAQ=Dysfunctional Analysis Questionnaire; EuroQol=health-related Quality Of Life; FESV=Fragebogen zur Erfassung der Schmerzverarbeitung; GAF=Global Assessment of Functioning; FLZM= Fragen zur Lebenszufriedenheit Module; HADS=Hospital Anxiety and Depression Scale; HRSA=Hamilton Rating Scale for Anxiety; HRSD=Hamilton Rating Scale for Depression; ICIDH= ; IIP=Inventory of Interpersonal Problems; IS=Impairment Score; MQ=methodological quality; PHQ=Patient Health Questionnaire; SCL-90=Symptom Checklist; SF-12/36=Short-Form health survey; SOMS=Screening für Somatoforme Störungen; SSD=somatic symptom diary; SSS=Severity of Somatic Symptoms scale; STAXI=State Trait Anger Expression Inventory. BEG=bioenergetic analysis; CBT=cognitive-behavioural therapy; EMC=extensive medical care; GYM=gymnastic exercises; PAT=paradoxical therapy; PCI=psychiatric consultation intervention; PDT=psychodynamic therapy; SM=soma management training; TAU=treatment as usual; Treatment frequency: high= >two sessions a week; moderate=1-2 sessions a week a. Sample size in brackets refers to number of patients analysed at posttreatment. b. Both conditions are analysed as active psychotherapeutic treatments. c. The additional treatments (biofeedback, relaxation) were offered in the first 2 weeks of a 6-week multi-modal in-patient treatment programme d. No active treatment condition was available. e. The categorisation of studies based on the PQRS is as follows: =<9 exceptionally ; 10-14: very ; 15-24: moderately ; 25-30: adequate to good; 31-34: moderately good; 35-48: very good; 49-50: exceptionally good. f. Patients in the CBT/acupuncture condition were treated as in-patients, since the acupuncture was provided five times a week. Those in the CBT condition were treated twice a week as out-patients.

3 Table DS2 Overview of therapeutic interventions Psychotherapeutic interventions Study Psycho- Education Motivational Behavioural Cognitive Affective Interpersonal Psychodynamic Body- Directed Experiential Mindfulness and Attention Nonverbal Allen et al. (2001) Allen et al. (2006) Ataoglu et al (2003) 42 Bleichhardt et al (2004) 45 Dongfen & Shizong (1999) 41 Hiller et al. (2003) Junkert Tress et al (2001) 40 Leichsenring et al (2008) 39 Moene et al. (2002) Moene et al. (2003) Nanke & Rief (2003) 9 Nickel et al. (2006) Sattel et al. (2012) Schneider & Rief (2007) 4 Tschuschke et al. (2007) =not important; - =possibly not important; + =possibly important; ++ =important; Psychoeducation= instructions about a theory of causal and maintaining mechanisms of the disorder; Motivational= increasing patients and therapists commitment to treatment and change; Behavioural= modifying adverse and dysfunctional behaviour; Cognitive=creating insight into and changing patterns of thinking; Affective=emphasizing emotional awareness, i.e., identifying, controlling and expressing emotions; Interpersonal=increasing a patient s (understanding of) maladaptive behavioural patterns in relating to other people; Psychodynamic= exploration and interpretation of conflicts, defences and (counter)transference; Body-directed= relaxation, respiratory or vocal exercises, massage, physical therapy, gymnastics, biofeedback, or acupuncture; Experiential=phenomenological and Gestalt therapies activating emotions related to a trauma, significant events or assumed to underlie the symptom; Mindfulness and Attention=derived mostly from Buddhism that aim to increase awareness of mind states; Nonverbal=art, drama and other expressive components

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