A systematic review and meta-analysis found that a tailored module that includes psychological interventions for patients with Medically Unexplained Physical Symptoms (MUPS) may improve care and overall functioning. These findings were published in General Hospital Psychiatry.
Investigators from the All India Institute of Medical Sciences searched publication databases for studies published between 2010 and 2021 of interventions for patients presenting with MUPS. This systematic review included 12 studies and 7 meta-analyses.
The study samples sizes ranged from 28 to 341 patients with MUPS, for a total sample size in this analysis of 1424. Patients were aged 18 to 80 years and they had many psychiatric and physical comorbidities.
The studied interventions included mindfulness-based cognitive therapy, cognitive-behavioral therapy, psychophysiological treatment, and emotional regulation training. Control groups received standard medical care, enhanced medical care, waitlist, or other psychological interventions.
Overall, interventions for MUPS had a significant effect on somatic symptom severity (standardized mean difference [SMD], -0.559; 95% CI, -0.852 to -0.267; I2, 88%; P <.001) and depressive symptoms (SMD, -0.755; 95% CI, -1.420 to -0.089; I2, 87%; P <.001).
Stratified by individual studies, 3 of the 7 reported significant improvements in somatic symptom severity and 2 reported significant effects on depressive symptoms.
No significant effect was reported for anxiety symptoms (SMD, -0.333; 95% CI, -1.218 to 0.552; I2, 76%; P <.001), physical component summary (SMD, 6.358; 95% CI, -11.290 to 23.965; I2, 99%; P <.001), or mental component summary (SMD, 12.683; 95% CI, -10.694 to 36.060; I2, 100%; P <.001) overall.
Stratified by individual study, 1 study of 7 found significant improvement in anxiety symptoms. For the physical component summary, no individual studies reported significant changes. Of the 5 studies which reported effects using the mental component summary, 2 reported significant decreases.
This study was limited by the significant heterogeneity in each of the analyses.
The study authors concluded, “People with MUPS are often found to have higher levels of disability, psychological distress, and a deteriorated quality of life. Apart from pharmacological treatment, psychological interventions can be possibly beneficial in treating the psychological comorbidities associated with MUPS. […] A tailored module including psychological interventions may be useful in dealing with these patients in primary care to improve the overall functioning of the individuals.”
Kaur T, Ranjan P, Sarkar S, et al. Psychological interventions for medically unexplained physical symptoms: A systematic review and meta-analysis. Gen Hosp Psychiatry. Published online April 18, 2022. doi:10.1016/j.genhosppsych.2022.04.006