Kaur Tanveer, Ranjan Piyush, Sarkar Siddharth, Kaloiya Gauri Shanker, Khan Munnoo, Bhatia Harpreet
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Gen Hosp Psychiatry. 2022 Jul-Aug;77:92-101. doi: 10.1016/j.genhosppsych.2022.04.006. Epub 2022 Apr 18.
Individuals seeking treatment for physical symptoms having unknown etiology are common in the primary healthcare setup. Factors such as biomedical, environmental, social, and psychological ones are expected to play an important role in the treatment of Medically Unexplained Physical Symptoms (MUPS). Therefore, this systematic review and meta-analysis aimed to investigate the efficacy of psychological interventions for the treatment of MUPS.
Studies were selected using different electronic databases (PubMed, Wiley, Cochrane), to identify RCTs published in the last 11 years on psychological interventions to treat MUPS. A total of 12 studies were finalized for systematic review and 7 for meta-analysis based on the inclusion criteria. The risk of bias was assessed by the two reviewers independently using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions. OpenMeta[Analyst] was used to perform meta-analysis.
The findings revealed that psychological interventions can possibly be effective in treating patients with MUPS. Somatic symptom severity and depression improved in the intervention groups as compared to controls, while anxiety, and physical and mental component summary of Short-Form General Health Survey 36 did not significantly improve in the intervention group.
A tailored module including psychological interventions to deal with these patients in primary care may be useful in improving the overall functioning of the individuals.
在初级医疗保健机构中,因不明病因的身体症状而寻求治疗的个体很常见。生物医学、环境、社会和心理等因素预计在不明原因身体症状(MUPS)的治疗中发挥重要作用。因此,本系统评价和荟萃分析旨在研究心理干预对治疗MUPS的疗效。
通过不同的电子数据库(PubMed、Wiley、Cochrane)选择研究,以识别过去11年中发表的关于心理干预治疗MUPS的随机对照试验(RCT)。根据纳入标准,共确定12项研究进行系统评价,7项进行荟萃分析。两位评价者独立使用《Cochrane系统评价干预措施手册》中概述的标准评估偏倚风险。使用OpenMeta[Analyst]进行荟萃分析。
研究结果显示,心理干预可能对治疗MUPS患者有效。与对照组相比,干预组的躯体症状严重程度和抑郁有所改善,而干预组的焦虑以及简短健康调查问卷36的身体和心理成分总结并未显著改善。
在初级保健中,一个包括心理干预在内的量身定制的模块可能有助于改善个体的整体功能,从而应对这些患者。