Neuropsychiatric Disease and Treatment (Sep 2017)
Cognitive behavioral therapy for somatic symptom disorders in later life: a prospective comparative explorative pilot study in two clinical populations
Abstract
Michelle JH Verdurmen,1 Arjan C Videler,2 Astrid M Kamperman,3 David Khasho,4 Christina M van der Feltz-Cornelis4,5 1Department of Personality Disorders, GGz Breburg, Tilburg, 2Department of Geriatric Psychiatry, GGz Breburg, Tilburg, 3Department of Psychiatry, Erasmus University Medical Center, Epidemiological and Social Psychiatric Research Institute, Rotterdam, 4Clinical Center of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, 5Department of Tranzo, Tilburg University, Tilburg, The Netherlands Background: Elderly patients with somatic symptom disorder (SSD) put a great burden on the health care delivery system. Cognitive behavioral therapy (CBT) is effective in adults with SSD. However, no studies have been conducted yet into CBT for SSD in later life.Objectives: We explored the feasibility of CBT for SSD in the elderly.Methods: This is a prospective pilot study comparing two outpatient specialty mental health settings for adults (<60 years; n=13) and for elderly patients (≥60 years; n=9) with SSD. Intervention was 18 structured, protocoled, and supervised CBT sessions. Outcomes were somatic symptoms, pain intensity, pain disability, quality of life, depressive symptoms, and generalized anxiety symptoms. Feasibility of the CBT intervention was explored with self-developed questions, both for the therapists and the patients.Results: Both therapists and elderly patients evaluated the treatment as positive. Somatic symptoms improved significantly in the adult group but not in the elderly group. There was a large, significant decrease in pain intensity and pain disability in elderly patients compared to the adults. Social functioning, vitality, and anxiety symptoms improved significantly in the adults. Presence of chronic medical conditions did not influence these results.Conclusion: This study shows that CBT is feasible as a treatment for SSD in older adults and has encouraging results. Replication in an RCT is warranted. Keywords: somatic symptom disorder, somatoform disorder, pain, elderly, medically unexplained symptoms
