A Randomized Double-Blind Controlled Trial Comparing Davanloo Intensive Short-Term Dynamic Psychotherapy as Internet-Delivered Vs Treatment as Usual for Medically Unexplained Pain: A 6-Month Pilot Study

Psychosomatics. May-Jun 2016;57(3):292-300. doi: 10.1016/j.psym.2016.01.001. Epub 2016 Jan 6.

Abstract

Background: Research has shown that Intensive Short-Term Dynamic Psychotherapy (ISTDP) can effectively decrease pain intensity and improve quality of life in patients with medically unexplained pain.

Objective: Understanding that not all patients with medically unexplained pain have access to in-person ISTDP, this study aims to investigate the efficacy of an Internet-delivered ISTDP for individuals with medically unexplained pain using Skype in comparison with treatment as usual.

Method: In this randomized controlled trial, 100 patients were randomly allocated into Internet-delivered ISTDP (n = 50) and treatment-as- usual (n = 50) groups. Treatment intervention consisted of 16 weekly, hour-long therapy sessions. The primary outcome was perceived pain assessed using the Numeric Pain Rating Scale. The secondary outcome included Depression Anxiety Stress Scale-21, Emotion Regulation Questionnaire, Mindful Attention Awareness Scale, and Quality-of-Life Inventory. Blind assessments were conducted at the baseline, posttreatment, and at a 6-month follow-up.

Results: In the intention-to-treat analysis, pain symptoms in the intervention group were significantly reduced (p < 0.001), whereas a reduction was not observed in the treatment as usual group (p = 0.651). Moreover, there were significant decreases in depression, anxiety, and stress, as well as a greater increase in emotion regulation functioning, mindfulness, and quality of life observed in the intervention group 6 months after the treatment compared with the treatment as usual condition.

Conclusion: The results of this pilot trial demonstrate that 16 weeks of ISTDP delivered by Skype can significantly improve pain intensity and clinical symptoms of medically unexplained pain.

Keywords: intensive short-term dynamic psychotherapy; medically unexplained pain; somatization; telemedicine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety / psychology
  • Depression / psychology
  • Double-Blind Method
  • Female
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Mindfulness
  • Pain / psychology*
  • Pain Management / methods*
  • Pilot Projects
  • Psychotherapy, Brief / methods*
  • Psychotherapy, Psychodynamic / methods*
  • Quality of Life / psychology
  • Self-Control
  • Somatoform Disorders / psychology
  • Somatoform Disorders / therapy*
  • Stress, Psychological / psychology
  • Telemedicine / methods*
  • Treatment Outcome