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1. Interoception and Psychopathology

Author

Medford, Nick, Quadt, Lisa, Critchley, Hugo, Mishara, Aaron L., editor, Moskalewicz, Marcin, editor, Schwartz, Michael A., editor, and Kranjec, Alexander, editor

Published
2024
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10. Psychological and demographic characteristics of 368 patients with dissociative seizures: data from the CODES cohort

Author

Goldstein, Laura H., Robinson, Emily J., Mellers, John D. C., Stone, Jon, Carson, Alan, Chalder, Trudie, Reuber, Markus, Eastwood, Carole, Landau, Sabine, McCrone, Paul, Moore, Michele, Mosweu, Iris, Murray, Joanna, Perdue, Iain, Pilecka, Izabela, Richardson, Mark P., Medford, Nick, CODES Study Group, and Smith, Phillip

Subjects
Male, media_common.quotation_subject, dissociative seizures, Comorbidity, Dissociative Disorders, Anxiety, Hyperkinesis, Psychological Distress, Personality Disorders, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Seizures, medicine, Humans, Personality, 030212 general & internal medicine, Age of Onset, Poverty, Applied Psychology, Depression (differential diagnoses), media_common, Psychiatric Status Rating Scales, Psychopathology, business.industry, Age at onset, psychopathology, medicine.disease, Psychiatry and Mental health, Distress, Medically Unexplained Symptoms, functional impairment, quality of life, Cohort, RC Internal medicine, Female, Original Article, medicine.symptom, business, 030217 neurology & neurosurgery, Agoraphobia, Clinical psychology
Abstract

BackgroundWe examined demographic, clinical, and psychological characteristics of a large cohort (n = 368) of adults with dissociative seizures (DS) recruited to the CODES randomised controlled trial (RCT) and explored differences associated with age at onset of DS, gender, and DS semiology.MethodsPrior to randomisation within the CODES RCT, we collected demographic and clinical data on 368 participants. We assessed psychiatric comorbidity using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and a screening measure of personality disorder and measured anxiety, depression, psychological distress, somatic symptom burden, emotional expression, functional impact of DS, avoidance behaviour, and quality of life. We undertook comparisons based on reported age at DS onset (v. ⩾40), gender (male v. female), and DS semiology (predominantly hyperkinetic v. hypokinetic).ResultsOur cohort was predominantly female (72%) and characterised by high levels of socio-economic deprivation. Two-thirds had predominantly hyperkinetic DS. Of the total, 69% had ⩾1 comorbid M.I.N.I. diagnosis (median number = 2), with agoraphobia being the most common concurrent diagnosis. Clinical levels of distress were reported by 86% and characteristics associated with maladaptive personality traits by 60%. Moderate-to-severe functional impairment, high levels of somatic symptoms, and impaired quality of life were also reported. Women had a younger age at DS onset than men.ConclusionsOur study highlights the burden of psychopathology and socio-economic deprivation in a large, heterogeneous cohort of patients with DS. The lack of clear differences based on gender, DS semiology and age at onset suggests these factors do not add substantially to the heterogeneity of the cohort.

Published
2020

11. Cognitive–behavioural therapy compared with standardised medical care for adults with dissociative non-epileptic seizures: the CODES RCT

Author

Goldstein, Laura H, primary, Robinson, Emily J, additional, Pilecka, Izabela, additional, Perdue, Iain, additional, Mosweu, Iris, additional, Read, Julie, additional, Jordan, Harriet, additional, Wilkinson, Matthew, additional, Rawlings, Gregg, additional, Feehan, Sarah J, additional, Callaghan, Hannah, additional, Day, Elana, additional, Purnell, James, additional, Baldellou Lopez, Maria, additional, Brockington, Alice, additional, Burness, Christine, additional, Poole, Norman A, additional, Eastwood, Carole, additional, Moore, Michele, additional, Mellers, John DC, additional, Stone, Jon, additional, Carson, Alan, additional, Medford, Nick, additional, Reuber, Markus, additional, McCrone, Paul, additional, Murray, Joanna, additional, Richardson, Mark P, additional, Landau, Sabine, additional, and Chalder, Trudie, additional

Published
2021
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15. Emotional memory and perception of emotional faces in patients suffering from depersonalization disorder

Author

Montagne, Barbara, Sierra, Mauricio, Medford, Nick, Hunter, Elaine, Baker, Dawn, Kessels, Roy P.C., Haan, Edward H.F. de, and David, Anthony S.

Subjects
Depersonalization -- Causes of, Depersonalization -- Diagnosis, Facial expression -- Analysis, Noradrenaline -- Evaluation, Psychology and mental health
Abstract

Emotional processing in patients with depersonalization disorder (DPD) focusing on recognizing emotional faces and memory of emotional events is analyzed. The results indicate that patients with DPD showed deficits in relation to a fear-including facial expression.

Published
2007

17. Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial

Author

Goldstein, Laura H, primary, Robinson, Emily J, additional, Mellers, John D C, additional, Stone, Jon, additional, Carson, Alan, additional, Reuber, Markus, additional, Medford, Nick, additional, McCrone, Paul, additional, Murray, Joanna, additional, Richardson, Mark P, additional, Pilecka, Izabela, additional, Eastwood, Carole, additional, Moore, Michele, additional, Mosweu, Iris, additional, Perdue, Iain, additional, Landau, Sabine, additional, Chalder, Trudie, additional, Abe, A-M, additional, Adab, N, additional, Agrawal, N, additional, Allroggen, H, additional, Alvares, D, additional, Andrews, T, additional, Angus-Leppan, H, additional, Aram, J, additional, Armstrong, R, additional, Atalaia, A, additional, Bagary, M, additional, Baldellou Lopez, M, additional, Bennett, M, additional, Black, T, additional, Blackburn, D, additional, Bodani, M, additional, Broadhurst, M, additional, Brockington, A, additional, Bruno, E, additional, Buckley, M, additional, Burness, C, additional, Callaghan, H, additional, Chalmers, R, additional, Chong, S, additional, Chowdhury, M, additional, Chowdury, F, additional, Cikurel, K, additional, Cocco, G, additional, Cock, H, additional, Cooper, S, additional, Cope, S, additional, Copping, A, additional, Day, E, additional, Delamont, R, additional, Dennis, G, additional, Derry, C, additional, Devlin, R, additional, Dickson, J.M., additional, Diehl, B, additional, Donnelly, C, additional, Duncan, S, additional, Edwards, M, additional, Ellawella, S, additional, Ellis, C, additional, Elvish, J, additional, Elwes, R, additional, Eriemo, S, additional, Eriksson, S, additional, Evans, K, additional, Faruqui, R, additional, Feehan, S, additional, Finnerty, G, additional, Flores, L, additional, Firth, N, additional, Fung, R, additional, Gardiner, P, additional, Graham, C, additional, Green-Thompson, Z, additional, Grunewald, R, additional, Hadden, R, additional, Hamandi, K, additional, Harding, R, additional, Harikrishnan, S, additional, Harrison, S, additional, Healy, H, additional, Hewamadduma, C, additional, Higgins, S, additional, Howell, S, additional, Hunt, H, additional, Hussain, A, additional, Innocente, M, additional, Jensch, G, additional, Johnson, M, additional, Jordan, H, additional, Karlsson, J, additional, Kelso, A, additional, Kemp, S, additional, Knibb, J, additional, Kock, N, additional, Koutroumanidis, M, additional, Kovac, S, additional, Kumar, G, additional, Laker, A, additional, Leschziner, G, additional, Liu, R, additional, Lozsadi, D, additional, Ludwig, L, additional, MacDonald, B, additional, MacGregor, L, additional, Maguire, M, additional, Manford, M, additional, Martino, D, additional, McCorry, D, additional, McGorlick, A, additional, McKeown, K, additional, McKevitt, F, additional, Meadow, A, additional, Memon, S, additional, Miorelli, A, additional, Mitchell, C, additional, Mitchell, T.N., additional, Moffitt, V, additional, Moran, N, additional, Morgan-Boon, A, additional, Moriarty, J, additional, Mula, M, additional, Mullatti, N, additional, Nashef, L, additional, O'Hara, D, additional, Oakley, L, additional, O'Sullivan, S, additional, Page, L, additional, Patel, D, additional, Petrochilos, P, additional, Phoenix, D, additional, Pickerell, W, additional, Pieters, T, additional, Poole, N, additional, Price, G, additional, Protheroe, D, additional, Pullicino, P, additional, Purnell, J, additional, Quirk, J, additional, Rajakulendran, S, additional, Read, J, additional, Ridha, B, additional, Rockliffe-Fidler, C, additional, Rowbottom, C, additional, Rugg-Gunn, F, additional, Sachar, A, additional, Saha, R, additional, Saldanha, G, additional, Samarasekera, S, additional, Sanchez Sanchez, V, additional, Santhouse, A, additional, Scholes, K, additional, Shetty, A, additional, Shotbolt, P, additional, Simkiss, R, additional, Singh, J, additional, Sivagnanasundaram, J, additional, Slaght, S, additional, Smith, P, additional, Sokhi, D, additional, Stanton, B, additional, Suvorova, L, additional, Tahir, T, additional, Taylor, R, additional, Teare, L, additional, Tedesco, L, additional, Teo, J, additional, Thorpe, J, additional, Toplis, L, additional, Tsakopoulou, M, additional, Tylova, I, additional, Vick, T, additional, Vinnicombe, J, additional, Walker, M, additional, Walsh, C, additional, Watson, G, additional, Webb, T, additional, Wehner, T, additional, Welch, K, additional, Weyrich, K, additional, Whittaker, M, additional, Wickremaratchi, M, additional, Wicks, L, additional, and Yogarajah, M, additional

Published
2020
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18. Psychological and demographic characteristics of 368 patients with dissociative seizures: data from the CODES cohort.

Author

Goldstein, Laura H., Robinson, Emily J., Mellers, John D. C., Stone, Jon, Carson, Alan, Chalder, Trudie, Reuber, Markus, Eastwood, Carole, Landau, Sabine, McCrone, Paul, Moore, Michele, Mosweu, Iris, Murray, Joanna, Perdue, Iain, Pilecka, Izabela, Richardson, Mark P., and Medford, Nick

Subjects
PERSONALITY disorders, DISSOCIATIVE disorders, FUNCTIONAL status, AGE distribution, SOCIOECONOMIC factors, AGORAPHOBIA, PATHOLOGICAL psychology, SYMPTOMS, MENTAL depression, QUALITY of life, AGE factors in disease, DESCRIPTIVE statistics, SEIZURES (Medicine), ANXIETY, PSYCHOLOGICAL distress, PSYCHOLOGICAL factors
Abstract

Background: We examined demographic, clinical, and psychological characteristics of a large cohort (n = 368) of adults with dissociative seizures (DS) recruited to the CODES randomised controlled trial (RCT) and explored differences associated with age at onset of DS, gender, and DS semiology. Methods: Prior to randomisation within the CODES RCT, we collected demographic and clinical data on 368 participants. We assessed psychiatric comorbidity using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and a screening measure of personality disorder and measured anxiety, depression, psychological distress, somatic symptom burden, emotional expression, functional impact of DS, avoidance behaviour, and quality of life. We undertook comparisons based on reported age at DS onset (<40 v. ⩾40), gender (male v. female), and DS semiology (predominantly hyperkinetic v. hypokinetic). Results: Our cohort was predominantly female (72%) and characterised by high levels of socio-economic deprivation. Two-thirds had predominantly hyperkinetic DS. Of the total, 69% had ⩾1 comorbid M.I.N.I. diagnosis (median number = 2), with agoraphobia being the most common concurrent diagnosis. Clinical levels of distress were reported by 86% and characteristics associated with maladaptive personality traits by 60%. Moderate-to-severe functional impairment, high levels of somatic symptoms, and impaired quality of life were also reported. Women had a younger age at DS onset than men. Conclusions: Our study highlights the burden of psychopathology and socio-economic deprivation in a large, heterogeneous cohort of patients with DS. The lack of clear differences based on gender, DS semiology and age at onset suggests these factors do not add substantially to the heterogeneity of the cohort. [ABSTRACT FROM AUTHOR]

Published
2021
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23. T149. METACOGNITIVE DEFICITS IN INTEROCEPTION ARE ASSOCIATED WITH DISSOCIATIVE EXPERIENCES IN PATIENTS WITH FIRST EPISODE PSYCHOSIS

Author

Medford Nick, Anil K. Seth, Cassandra D. Gould van Praag, Kathy Greenwood, Sarah N. Garfinkel, Hugo D. Critchley, Geoff Davies, and Charlotte L. Rae

Subjects
Psychiatry and Mental health, Abstracts, Poster Session I, medicine.drug_class, First episode psychosis, medicine, Interoception, Metacognition, In patient, Dissociative, Psychology, Clinical psychology
Abstract

Background Dissociative experiences, including depersonalization and derealisation, represent perturbations of consciousness and selfhood, and are commonly reported by patients during early stages of a psychotic illness. The continuity and integrity of a conscious sense of self is proposed to be grounded upon the control of internal physiological state and its predictive representation through interoception, i.e. the sensing of internal bodily changes. We tested the hypothesized relationship between dissociation and interoceptive deficits in patients with first episode psychosis (FEP), combining behavioural testing with functional neuroimaging. Methods Individuals with first episode psychosis (N=41) and matched community control participants (N=21) performed an interoceptive task (heart-tone synchrony judgments) during functional magnetic resonance imaging (fMRI). Trial-by-trial confidence ratings indexed subjective performance, and measures of metacognitive interoceptive awareness (insight) were derived from confidence-accuracy correspondence. We tested for regional brain activity relating to dissociative symptom scores and objective, subjective and metacognitive aspects of interoception. Results In patients with FEP, metacognitive impairments in interoception predicted magnitude of dissociative symptoms, accompanied by hypoactivation of right insula cortex. Other dimensions of interoception, and accuracy, confidence and metacognitive insight on an exteroceptive task were unrelated to dissociative symptoms and there were no group differences between FEP patient and control groups. Discussion Our findings suggest that symptoms of disturbed conscious integrity and selfhood in early psychosis arise through selective disruption of higher-order metacognitive representations of interoceptive signals. Brain systems supporting the conscious integration of bodily feelings may represent a target for interventions to enhance functioning and, speculatively, mitigate illness progression in psychosis.

Published
2018

26. COgnitive behavioural therapy versus standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES): statistical and economic analysis plan for a randomised controlled trial

Author

Robinson, Emily J., primary, Goldstein, Laura H., additional, McCrone, Paul, additional, Perdue, Iain, additional, Chalder, Trudie, additional, Mellers, John D. C., additional, Richardson, Mark P., additional, Murray, Joanna, additional, Reuber, Markus, additional, Medford, Nick, additional, Stone, Jon, additional, Carson, Alan, additional, and Landau, Sabine, additional

Published
2017
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27. Characteristics of 698 patients with dissociative seizures: A UK multicenter study.

Author

Goldstein, Laura H., Robinson, Emily J., Reuber, Markus, Chalder, Trudie, Callaghan, Hannah, Eastwood, Carole, Landau, Sabine, McCrone, Paul, Medford, Nick, Mellers, John D. C., Moore, Michele, Mosweu, Iris, Murray, Joanna, Perdue, Iain, Pilecka, Izabela, Richardson, Mark P., Carson, Alan, Stone, Jon, Abe, Anne‐Mary, and Adab, Naghme

Subjects
SEIZURES (Medicine), PSYCHOGENIC nonepileptic seizures, DEMOGRAPHIC characteristics, COGNITIVE therapy, AGE of onset, AGE distribution
Abstract

Objective: We aimed to characterize the demographics of adults with dissociative (nonepileptic) seizures, placing emphasis on distribution of age at onset, male:female ratio, levels of deprivation, and dissociative seizure semiology. Methods: We collected demographic and clinical data from 698 adults with dissociative seizures recruited to the screening phase of the CODES (Cognitive Behavioural Therapy vs Standardised Medical Care for Adults With Dissociative Non‐Epileptic Seizures) trial from 27 neurology/specialist epilepsy clinics in the UK. We described the cohort in terms of age, age at onset of dissociative seizures, duration of seizure disorder, level of socioeconomic deprivation, and other social and clinical demographic characteristics and their associations. Results: In what is, to date, the largest study of adults with dissociative seizures, the overall modal age at dissociative seizure onset was 19 years; median age at onset was 28 years. Although 74% of the sample was female, importantly the male:female ratio varied with age at onset, with 77% of female but only 59% of male participants developing dissociative seizures by the age of 40 years. The frequency of self‐reported previous epilepsy was 27%; nearly half of these epilepsy diagnoses were retrospectively considered erroneous by clinicians. Patients with predominantly hyperkinetic dissociative seizures had a shorter disorder duration prior to diagnosis in this study than patients with hypokinetic seizures (P < .001); dissociative seizure type was not associated with gender. Predominantly hyperkinetic seizures were most commonly seen in patients with symptom onset in their late teens. Thirty percent of the sample reported taking antiepileptic drugs; this was more common in men. More than 50% of the sample lived in areas characterized by the highest levels of deprivation, and more than two‐thirds were unemployed. Significance: Females with dissociative seizures were more common at all ages, whereas the proportion of males increased with age at onset. This disorder was associated with socioeconomic deprivation. Those with hypokinetic dissociative seizures may be at risk for delayed diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Published
2019
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29. Fractionating the unitary notion of dissociation disembodied but not embodied dissociative

Author

Braithwaite, Jason J, James, Kelly, Dewe, Hayley, Medford, Nick, and Takahashi, Chie

Subjects
RC0321, RC
Abstract

It has been argued that hallucinations which appear to involve shifts in egocentric\ud perspective (e.g., the out-of-body experience, OBE) reflect specific biases in exocentric\ud perspective-taking processes. Via a newly devised perspective-taking task, we examined\ud whether such biases in perspective-taking were present in relation to specific dissociative\ud anomalous body experiences (ABE) – namely the OBE. Participants also completed\ud the Cambridge Depersonalization Scale (CDS; Sierra and Berrios, 2000) which provided\ud measures of additional embodied ABE (unreality of self) and measures of derealization\ud (unreality of surroundings).There were no reliable differences in the level of ABE, emotional\ud numbing, and anomalies in sensory recall reported between the OBE and control group\ud as measured by the corresponding CDS subscales. In contrast, the OBE group did\ud provide significantly elevated measures of derealization (“alienation from surroundings”\ud CDS subscale) relative to the control group. At the same time we also found that the\ud OBE group was significantly more efficient at completing all aspects of the perspectivetaking\ud task relative to controls. Collectively, the current findings support fractionating\ud the typically unitary notion of dissociation by proposing a distinction between embodied\ud dissociative experiences and disembodied dissociative experiences – with only the latter\ud being associated with exocentric perspective-taking mechanisms. Our findings – obtained\ud with an ecologically valid task and a homogeneous OBE group – also call for a reevaluation\ud of the relationship between OBEs and perspective-taking in terms of facilitated\ud disembodied experiences.

Published
2013

30. Fractionating the unitary notion of dissociation:disembodied but not embodied dissociative experiences are associated with exocentric perspective-taking

Author

Braithwaite, Jason J., James, Kelly, Dewe, Hayley, Medford, Nick, Takahashi, Chie, and Kessler, Klaus

Abstract

It has been argued that hallucinations which appear to involve shifts in egocentric perspective (e.g., the out-of-body experience, OBE) reflect specific biases in exocentric perspective-taking processes. Via a newly devised perspective-taking task, we examined whether such biases in perspective-taking were present in relation to specific dissociative anomalous body experiences (ABE) - namely the OBE. Participants also completed the Cambridge Depersonalization Scale (CDS; Sierra and Berrios, 2000) which provided measures of additional embodied ABE (unreality of self) and measures of derealization (unreality of surroundings). There were no reliable differences in the level of ABE, emotional numbing, and anomalies in sensory recall reported between the OBE and control group as measured by the corresponding CDS subscales. In contrast, the OBE group did provide significantly elevated measures of derealization ("alienation from surroundings" CDS subscale) relative to the control group. At the same time we also found that the OBE group was significantly more efficient at completing all aspects of the perspective-taking task relative to controls. Collectively, the current findings support fractionating the typically unitary notion of dissociation by proposing a distinction between embodied dissociative experiences and disembodied dissociative experiences - with only the latter being associated with exocentric perspective-taking mechanisms. Our findings - obtained with an ecologically valid task and a homogeneous OBE group - also call for a re-evaluation of the relationship between OBEs and perspective-taking in terms of facilitated disembodied experiences.

Published
2013

31. COgnitive behavioural therapy vs standardised medical care for adults with Dissociative non-Epileptic Seizures (CODES): a multicentre randomised controlled trial protocol

Author

Goldstein, Laura H., primary, Mellers, John D. C., additional, Landau, Sabine, additional, Stone, Jon, additional, Carson, Alan, additional, Medford, Nick, additional, Reuber, Markus, additional, Richardson, Mark, additional, McCrone, Paul, additional, Murray, Joanna, additional, and Chalder, Trudie, additional

Published
2015
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33. Emotional modulation of visual cortex activity: A functional nearinfrared spectroscopy study

Author

Minati, Ludovico, Jones, Catherine L., Gray, Marcus A., and Medford, Nick

Subjects
BF0309, genetic structures, RC0321, BF, BF0511, RC
Abstract

Functional neuroimaging and electroencephalography reveal emotional effects in early visual cortex.\ud Here, we used fNIRS to examine haemodynamic responses evoked by neutral, positive and negative emotional pictures, matched for brightness, contrast, hue, saturation, spatial frequency and entropy.\ud Emotion content modulated amplitude and latency of oxy-, deoxy- and total haemoglobin response peaks, and induced peripheral autonomic reactions. The processing of positive and negative pictures enhanced haemodynamic response amplitude, and this effect was paralleled by blood pressure changes. The processing of positive pictures was reflected in reduced haemodynamic response peak latency. Together these data suggest early visual cortex holds amplitude-dependent representation of stimulus salience and latency-dependent information regarding stimulus valence, providing new insight into affective interaction with sensory processing.

Published
2009

35. Fractionating the unitary notion of dissociation:disembodied but not embodied dissociative experiences are associated with exocentric perspective-taking

Author

Braithwaite, Jason J, James, Kelly, Dewe, Hayley, Medford, Nick, Takahashi, Chie, Kessler, Klaus, Braithwaite, Jason J, James, Kelly, Dewe, Hayley, Medford, Nick, Takahashi, Chie, and Kessler, Klaus

Abstract

It has been argued that hallucinations which appear to involve shifts in egocentric perspective (e.g., the out-of-body experience, OBE) reflect specific biases in exocentric perspective-taking processes. Via a newly devised perspective-taking task, we examined whether such biases in perspective-taking were present in relation to specific dissociative anomalous body experiences (ABE) – namely the OBE. Participants also completed the Cambridge Depersonalization Scale (CDS; Sierra and Berrios, 2000) which provided measures of additional embodied ABE (unreality of self) and measures of derealization (unreality of surroundings). There were no reliable differences in the level of ABE, emotional numbing, and anomalies in sensory recall reported between the OBE and control group as measured by the corresponding CDS subscales. In contrast, the OBE group did provide significantly elevated measures of derealization (“alienation from surroundings” CDS subscale) relative to the control group. At the same time we also found that the OBE group was significantly more efficient at completing all aspects of the perspective-taking task relative to controls. Collectively, the current findings support fractionating the typically unitary notion of dissociation by proposing a distinction between embodied dissociative experiences and disembodied dissociative experiences – with only the latter being associated with exocentric perspective-taking mechanisms. Our findings – obtained with an ecologically valid task and a homogeneous OBE group – also call for a re-evaluation of the relationship between OBEs and perspective-taking in terms of facilitated disembodied experiences.

Published
2013

50. Trust, belief and transitions: people’s experiences of multidisciplinary inpatient treatment for persistent physical symptoms. A qualitative study.

Author

Lewis, Hilary, Jinadu, Helen, Kelley, Rachael, Medford, Nick, Trigwell, Peter, and Guthrie, Elspeth

Abstract

AbstractPurposeMaterials and MethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONPeople with Persistent Physical Symptoms experience physical symptoms that are not wholly explained by a medical disorder or disease. Multidisciplinary treatment is recommended for people with severe difficulties and is provided in a small number of specialist centres in the UK. Only brief descriptions of this treatment are available, and the experiences of people receiving this treatment as an inpatient have not been explored. This study aimed to explore how people with persistent physical symptoms experience inpatient treatment from a specialist multidisciplinary team, and to identify which factors facilitated their engagement in the rehabilitation.18 people who had received inpatient multidisciplinary treatment for persistent physical symptoms participated in semi-structured interviews. The transcripts were analysed using reflexive thematic analysis.Participants’ experiences were influenced by whether they felt believed by the healthcare team, and whether they could place their own trust and belief in the staff team and the treatment approach. Their experiences involved a series of transitions; both in environment and understanding.Improvements are possible for people receiving inpatient multidisciplinary treatment for severe PPS. Trusting relationships between patients and staff members take time to develop but play a major role in patients’ experiences of treatment.People with persistent physical symptoms view the building of trusting relationships with rehabilitation professionals as a vital component of specialist treatmentPatients value the interpersonal style of the professional as much as the content of the intervention delivered.Developing an alliance and a shared understanding of symptoms takes time, high levels of tailoring, and a skilled multidisciplinary teamPatients found abrupt discharge difficult, and desire easier access to appropriate follow upPeople with persistent physical symptoms view the building of trusting relationships with rehabilitation professionals as a vital component of specialist treatmentPatients value the interpersonal style of the professional as much as the content of the intervention delivered.Developing an alliance and a shared understanding of symptoms takes time, high levels of tailoring, and a skilled multidisciplinary teamPatients found abrupt discharge difficult, and desire easier access to appropriate follow up [ABSTRACT FROM AUTHOR]

Published
2024
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