Efficacy of short-term psychotherapy for multiple medically unexplained physical symptoms: a meta-analysis

Abstract

Multiple medically unexplained physical symptoms (MUPS) are considered to be difficult and costly to treat. The current meta-analysis therefore investigates the efficacy of short-term psychotherapy for MUPS. Based on a multiple-phase literature search, studies were selected according to a-priori defined inclusion criteria. The standardized mean gain was used as the effect size index. Separate data aggregation of between- and within-group contrasts was performed on the basis of a mixed effects model. Outcome variables were physical symptoms, disorder specific emotions, cognitions and behaviors, depressive symptoms, general psychopathology, functional impairment, and health care utilization. Based on 27 included studies, small between-group effect sizes (range: d(+)=0.06-d(+)=0.40) and small to large within-group effect sizes (range: d(+)=0.36-d(+)=0.80) were found for post-treatment and follow-up assessments for the different outcome variables. Significant moderator variables were identified as the type, mode, and setting of therapy, number of therapy sessions, profession of therapist, age and sex of patients, quality of diagnostic procedure, and the control of concomitant treatments. Implications of the results for clinical practice and future research are discussed.