Department of Psychology, Faculty of Social Studies, Masaryk University, Czech Republic.
Department of Psychology, Faculty of Social Studies, Masaryk University, Czech Republic.
J Psychosom Res. 2020 Jul;134:110124. doi: 10.1016/j.jpsychores.2020.110124. Epub 2020 Apr 22.
Although psychological treatments for patients suffering from medically unexplained physical symptoms (MUPS) show promising results, evidence for their effectiveness is still limited. The aim of this study was to review the existing empirical support for change mechanisms that explain treatment effect in terms of symptom intensity and symptom interference in the daily lives of patients.
A systematic database search was conducted. Sixty-seven eligible studies were found, and change mechanism effects were extracted from them. The data were subjected to a systematic review.
Fifteen change mechanisms were identified. Those receiving the most consistent support included Increasing symptom acceptance, Development of coping strategies, and Positive treatment expectations, although the last mechanism was investigated in only two studies. Almost all mechanisms received support for at least one type of outcome, either at post-treatment or at follow-up.
Although some empirical support exists for many mechanisms, some of them have received only marginal attention in empirical studies. These limitations prevented us from deriving more definite conclusions.
尽管针对患有医学无法解释的躯体症状（MUPS）的患者的心理治疗显示出有前景的结果，但这些治疗的有效性证据仍然有限。本研究的目的是回顾现有的实证支持，以解释治疗效果的变化机制，即从症状强度和对患者日常生活的症状干扰方面来解释。
进行了系统的数据库搜索。发现了 67 项符合条件的研究，并从中提取了变化机制效应。对数据进行了系统综述。
确定了 15 种变化机制。尽管最后一种机制仅在两项研究中进行了调查，但接受最多一致支持的机制包括增加对症状的接受度、发展应对策略和积极的治疗期望。几乎所有的机制都得到了至少一种结果的支持，无论是在治疗后还是随访时。
尽管许多机制都得到了一些实证支持，但其中一些机制在实证研究中只受到了很少的关注。这些局限性使我们无法得出更明确的结论。
