The effect of psychotherapy on functional medical disorders

Functional somatic disorders are common and costly, thereby driving the need for the development of effective brief treatment options. Short-term psychodynamic psychotherapy is one candidate treatment method. This study aimed to review and meta-analyze, where possible, randomized controlled trials (RCTs) of psychodynamic psychotherapy for functional somatic disorders.

Following a systematic search of the literature, a meta-analysis of available RCT groups to determine the effects of psychodynamic psychotherapy was performed on a range of outcomes after treatment, and medium- and long-term follow-ups.

Results showed that in the 17 RCTs included in the analysis, psychodynamic psychotherapy significantly outperformed minimal treatment, treatment as usual, or waiting list controls on somatic symptom measures at all time frames, with small to large magnitude effect sizes. Descriptive reviews of 5 RCTs suggest that psychodynamic psychotherapy performed at least as well as other bona fide psychological therapies. Limitations of this meta-analysis include small samples of studies and possible publication bias.

These findings support psychodynamic psychotherapy as a valid treatment option for diverse functional somatic disorders conditions resulting in somatic symptom reductions that persist over time. psychodynamic psychotherapy should be included in functional somatic disorders treatment guidelines.