Medically unexplained physical symptoms in primary care: a controlled study on the effectiveness of cognitive-behavioral treatment by the family physician

Psychosomatics. 2009 Sep-Oct;50(5):515-24. doi: 10.1176/appi.psy.50.5.515.


Background: Disabling medically unexplained physical symptoms occur in 16% of all patients in primary care.

Objective: The aim of this study was to assess the effectiveness of a cognitive-behavioral intervention by the family physician.

Method: In a controlled design with detailed information on patient selection, 6,409 patients were screened on somatoform disorder, and 65 participants were allocated to care-as-usual or the experimental condition.

Results: After 6 and 12 months, the cognitive-behavioral intervention by trained family physicians was not more effective than care-as-usual.

Conclusion: Possibly, the intensity of treatment was insufficient for the severe and persistent symptoms that were encountered in primary care.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Netherlands
  • Primary Health Care*
  • Psychiatric Status Rating Scales
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / therapy*
  • Surveys and Questionnaires
  • Treatment Outcome