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An interdisciplinary multimodal integrative healthcare program for somatic symptom disorder, with predominant (spinal) pain

Jaap Wijnen (UGent) , Geert Van ’T Hullenaar, Nicole Louise Gordon, Marc Lucas Pont, Marciano Wilhelmina Henricus Geijselaers, Jessica Van Oosterwijck (UGent) and Jeroen De Jong
(2023) PSYCHOTHERAPY RESEARCH. 33(5). p.581-594
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Abstract
Objective Although multimodal interventions are generally recommended in patients with long-term somatic symptom disorders (SSD), available evidence is limited. The current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program for patients with SSD and predominant (spinal) pain. Method The healthcare program consisted of two active treatment phases: main 20-week program and a 12-month relapse prevention program. Participants were 4453 patients diagnosed with SSD. The primary outcome was health-related quality of life (HRQoL) assessed using the RAND-36 (i.e., mental/physical component summary) and secondary outcomes included physical and psychological symptoms assessed using the Brief Symptom Inventory (BSI) and RAND-36 subscales. Mixed linear models were used to examine the effects of the multimodal healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of relapse prevention program (T3). Results Significant improvements were found from T0 to T2 for all primary variables (i.e., mental/physical component summary) and secondary variables (i.e., BSI/RAND-36 subscales), which were maintained until the end of the relapse prevention program (T3). Conclusion An interdisciplinary multimodal integrative treatment for SSD is effective for improving HRQoL and reducing physical and psychological symptoms. Keywords: somatic symptom disorder; multimodal intervention; spinal pain; behavioral therapy; psychosomatic; interdisciplinary
Titel: Interdisciplinaire totaalaanpak bij somatische-symptoomstoornis en aanhoudende wervelkolom gerelateerde pijnklachten Introductie: Hoewel multimodale interventies worden aanbevolen voor cliënten met een langdurige somatische-symptoomstoornis (SSD), is hiervoor nog onvoldoende wetenschappelijk bewijs. Deze studie evalueerde de effectiviteit van een interdisciplinaire totaalaanpak in de poliklinische S-GGZ, voor cliënten met een SSD en wervelkolom gerelateerde pijnklachten. De totaalaanpak kan het best beschreven worden als een multimodale cognitieve gedragstherapie, waarbij verschillende therapeutische technieken worden ingezet, afhankelijk van persoonlijke behoeften en problemen van de cliënt. Het verbeteren van kwaliteit van leven en stimuleren van eigenregievoering staan centraal in de totaalaanpak. Methode: Het gezondheidsprogramma bestaat uit 2 componenten: 20 weken intensief behandelprogramma en een aansluitend 12 maanden terugval preventieprogramma. Deelnemers waren 4453 cliënten met een SSD. Gezondheidsgerelateerde kwaliteit van leven (HRQoL), gemeten met de RAND-36 (mental/physical component summary), was de primaire uitkomstmaat en psychische en lichamelijke klachten, gemeten met de BSI en RAND-36 subschalen, waren secundaire uitkomstmaten. Mixed linear models zijn gebruikt om het effect te onderzoeken van het gezondheidsprogramma op primaire/secundaire uitkomstmaten, gemeten over 4 tijdpunten: start 20 weken programma (T0), halverwege 20 weken programma (T1), einde 20 weken programma (T2) en einde terugval preventieprogramma (T3). Resultaten: Resultaten laten een significante vooruitgang zien van T0 naar T2 voor alle primaire (mental/physical component summary) en secundaire uitkomstmaten (BSI/RAND-36 subschalen). Resultaten bleken duurzaam te zijn tot aan het einde van het terugval preventieprogramma (T3). Conclusie & Discussie: Een interdisciplinaire multimodale totaalaanpak voor cliënten met SSD en aanhoudende wervelkolom gerelateerde pijnklachten lijkt een effectieve behandeling te zijn voor het verbeteren van HRQoL en verminderen van psychische en lichamelijke klachten.
Keywords
somatic symptom disorder, multimodal intervention, spinal pain, behavioral therapy, psychosomatic, interdisciplinary, MEDICALLY UNEXPLAINED SYMPTOMS, COGNITIVE-BEHAVIORAL THERAPY, SOMATOFORM DISORDER, PHYSICAL SYMPTOMS, ANXIETY, METAANALYSIS, RELAPSE, INTERVENTIONS, DEPRESSION, EFFICACY

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MLA
Wijnen, Jaap, et al. “An Interdisciplinary Multimodal Integrative Healthcare Program for Somatic Symptom Disorder, with Predominant (Spinal) Pain.” PSYCHOTHERAPY RESEARCH, vol. 33, no. 5, 2023, pp. 581–94, doi:10.1080/10503307.2022.2144528.
APA
Wijnen, J., Van ’T Hullenaar, G., Gordon, N. L., Pont, M. L., Geijselaers, M. W. H., Van Oosterwijck, J., & De Jong, J. (2023). An interdisciplinary multimodal integrative healthcare program for somatic symptom disorder, with predominant (spinal) pain. PSYCHOTHERAPY RESEARCH, 33(5), 581–594. https://doi.org/10.1080/10503307.2022.2144528
Chicago author-date
Wijnen, Jaap, Geert Van ’T Hullenaar, Nicole Louise Gordon, Marc Lucas Pont, Marciano Wilhelmina Henricus Geijselaers, Jessica Van Oosterwijck, and Jeroen De Jong. 2023. “An Interdisciplinary Multimodal Integrative Healthcare Program for Somatic Symptom Disorder, with Predominant (Spinal) Pain.” PSYCHOTHERAPY RESEARCH 33 (5): 581–94. https://doi.org/10.1080/10503307.2022.2144528.
Chicago author-date (all authors)
Wijnen, Jaap, Geert Van ’T Hullenaar, Nicole Louise Gordon, Marc Lucas Pont, Marciano Wilhelmina Henricus Geijselaers, Jessica Van Oosterwijck, and Jeroen De Jong. 2023. “An Interdisciplinary Multimodal Integrative Healthcare Program for Somatic Symptom Disorder, with Predominant (Spinal) Pain.” PSYCHOTHERAPY RESEARCH 33 (5): 581–594. doi:10.1080/10503307.2022.2144528.
Vancouver
1.
Wijnen J, Van ’T Hullenaar G, Gordon NL, Pont ML, Geijselaers MWH, Van Oosterwijck J, et al. An interdisciplinary multimodal integrative healthcare program for somatic symptom disorder, with predominant (spinal) pain. PSYCHOTHERAPY RESEARCH. 2023;33(5):581–94.
IEEE
[1]
J. Wijnen et al., “An interdisciplinary multimodal integrative healthcare program for somatic symptom disorder, with predominant (spinal) pain,” PSYCHOTHERAPY RESEARCH, vol. 33, no. 5, pp. 581–594, 2023.
@article{01GSCMFD080K2RHYX55JXWRVF6,
  abstract     = {{Objective
Although multimodal interventions are generally recommended in patients with long-term somatic symptom disorders (SSD), available evidence is limited. The current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program for patients with SSD and predominant (spinal) pain.

Method
The healthcare program consisted of two active treatment phases: main 20-week program and a 12-month relapse prevention program. Participants were 4453 patients diagnosed with SSD. The primary outcome was health-related quality of life (HRQoL) assessed using the RAND-36 (i.e., mental/physical component summary) and secondary outcomes included physical and psychological symptoms assessed using the Brief Symptom Inventory (BSI) and RAND-36 subscales. Mixed linear models were used to examine the effects of the multimodal healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of relapse prevention program (T3).

Results
Significant improvements were found from T0 to T2 for all primary variables (i.e., mental/physical component summary) and secondary variables (i.e., BSI/RAND-36 subscales), which were maintained until the end of the relapse prevention program (T3).

Conclusion
An interdisciplinary multimodal integrative treatment for SSD is effective for improving HRQoL and reducing physical and psychological symptoms.

Keywords: somatic symptom disorder; multimodal intervention; spinal pain; behavioral therapy; psychosomatic; interdisciplinary}},
  author       = {{Wijnen, Jaap and Van ’T Hullenaar, Geert and Gordon, Nicole Louise and Pont, Marc Lucas and Geijselaers, Marciano Wilhelmina Henricus and Van Oosterwijck, Jessica and De Jong, Jeroen}},
  issn         = {{1050-3307}},
  journal      = {{PSYCHOTHERAPY RESEARCH}},
  keywords     = {{somatic symptom disorder,multimodal intervention,spinal pain,behavioral therapy,psychosomatic,interdisciplinary,MEDICALLY UNEXPLAINED SYMPTOMS,COGNITIVE-BEHAVIORAL THERAPY,SOMATOFORM DISORDER,PHYSICAL SYMPTOMS,ANXIETY,METAANALYSIS,RELAPSE,INTERVENTIONS,DEPRESSION,EFFICACY}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{581--594}},
  title        = {{An interdisciplinary multimodal integrative healthcare program for somatic symptom disorder, with predominant (spinal) pain}},
  url          = {{http://doi.org/10.1080/10503307.2022.2144528}},
  volume       = {{33}},
  year         = {{2023}},
}
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