Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up

article i nfo Objective: To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and func- tional somatic syndromes such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, de- fined as bodily distress syndrome (BDS). Methods: We randomized 119 patients to either mindfulness therapy (mindfulness-based stress reduction and some cognitive behavioral therapy elements for BDS) or to enhanced treatment as usual (2-hour special- ist medical care and brief cognitive behavioral therapy for BDS). The primary outcome measure was change in physical health (SF-36 Physical Component Summary) from baseline to 15-month follow-up. Results: The study is negative as we could not demonstrate a different development over time for the two groups (F(3,2674)=1.51, P=.21). However, in the mindfulness therapy group, improvement was obtained toward the end of treatment and it remained present at the 15-month follow-up, whereas the enhanced treatment as usual group achieved no significant change until 15-month follow-up. The change scores aver- aged half a standard deviation which amounts to a clinically significant change, 29% changed more than 1 standard deviation. Significant between-group differences were observed at treatment cessation. Conclusion: Mindfulness therapy is a feasible and acceptable treatment. The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms. Never- theless, considering the more rapid improvement following mindfulness, mindfulness therapy may be a po- tentially useful intervention in BDS patients. Clinically important changes that seem to be comparable to a CBT treatment approach were obtained. Further research is needed to replicate or even expand these findings.