Psychosomatic Intervention for Patients with Multisomatoform Disorder in Different Somatic Specialities

ISRCTN ISRCTN23215121
DOI https://doi.org/10.1186/ISRCTN23215121
Secondary identifying numbers 1359/05
Submission date
28/11/2005
Registration date
05/01/2006
Last edited
17/04/2012
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Study website

Contact information

Prof Peter Henningsen
Scientific

Dept. of Psychosomatics
University Hospital 'Rechts der Isar'
Langerstr. 3
Munich
81675
Germany

Phone +49 (0)89 4140 4310
Email p.henningsen@tum.de

Study information

Study designMulti-centre two-arm randomized controlled trial with major end point at 1-year follow-up, the guidelines of Good Clinical Practice (GCP) will be followed, reporting will follow the CONSORT rules.
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Not specified
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific title
Study acronymPISO
Study objectivesPatients with medically unexplained physical symptoms are 'high utilizers' of the health care system with high psychiatric co-morbidity and severe impairments in quality of life (QoL). There is preliminary evidence that psycho-dynamic-interpersonal therapy (PIT) is beneficial as it reduces the intensity of physical symptoms and increases quality of life. The trial interventions so far lacked generalizability over a larger clinical spectrum of disabling somatoform symptoms. We developed a multi-centre two-arm randomized controlled trial with a primary end point and follow-up after one year. PISO has two new aspects:
1. PISO uses a diagnostic category that is independent of the type of currently dominant symptom and therefore serves as a common point of reference
2. PISO uses a manualized psychotherapeutic intervention that is adapted to the specific lead symptom in the beginning, but later on emphasizes more general aspects of experiencing 'unexplained' physical symptoms across single functional syndromes and somatic specialities
In the trial, we test a bio-psycho-social model of change including psychobiological parameters like heart rate variability and prefrontal/limbic neural activations. If the intervention tested in PISO proves to be efficacious as compared to enhanced medical care it will be useful as an economic and versatile tool that is applicable in cooperation with psychosomatic medicine across a range of somatic specialities.
Ethics approval(s)05/08/2005, project number 1359/05
Health condition(s) or problem(s) studiedMultisomatoform Disorder
InterventionPsycho-dynamic-interpersonal therapy (PIT) as a special form of psychosomatic therapy will be compared to enhanced medical care.
Intervention typeOther
Primary outcome measureSF-36 Physical Component Summary (PCS): In patients with multi-somatoform disorder, symptom-related incapacity is best captured with the PCS. The German version of the SF-36 health survey short form has been validated and is sensitive to change, the assumed effect size of 0.50 is clinically relevant.
Secondary outcome measures1. IPQ, Brief Form: The brief form of the 'Illness Perception Questionnaire' (BIPQ, Broadbent et al. in submission) provides a quantitative measure of the components of illness representations that has been shown in treatment trials to be sensitive to change. The German version was developed and validated by Gaab (unpublished manuscript).
2. PHQ-D: The 'Patient Health Questionnaire', German version (PHQ-D) is a brief self-report measure for anxiety, depression and other mental disorders. Criterion validity was established with respect to diagnostic gold standards and the PHQ has proven to be a responsive and reliable measure of depression treatment outcome (Löwe et al. 2004).
3. SOMS-7: Seven-day version of the 'Screening for Somatoform Symptoms'. A 53-item instrument for the evaluation of treatment effects in somatoform disorders, covering all somatic symptoms occurring in somatization disorder, according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Statistical Classification of Diseases and Related Health Problems - tenth revision (ICD-10) (Rief and Hiller 2003).
4. Whiteley-Index-7: The seven-item version of the Whiteley Index, an established hypochondriasis scale first described by Pilowsky, was developed and validated by Christensen et al. (2003) specifically to assess treatment effects.
5. LEAS: The 'Levels of Emotional Awareness Scale' (Lane and Schwartz 1987, German version: Subic-Wrana et al. 2002) is a projective text based measure that assesses the capacity to describe own emotional experience and the one assumed in others. It will be used as a predictor variable conceptually related to the theory of change assumed for the treatment intervention.
6. Heart rate variability (HRV): HRV measurement and analysis equipment will be present at each centre. Time-domain (RMSSD) and frequency domain (HF-HRV) analysis will be performed during a stress test with the emotional stroop paradigm.
Overall study start date01/01/2006
Completion date31/12/2008

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants176
Key inclusion criteria1. Patients screened positive and diagnosed in a structured interview in different somatic specialities with a diagnosis of pain-predominant multi-somatoform disorder and a quality of life (QoL) of 1 standard deviation below population norm in the SF-36
2. Signed informed consent
Key exclusion criteria1. Age younger than 18 years
2. Insufficient German language ability
3. Insufficient cognitive abilities (Mini Mental State <24)
4. Severe and chronic somatic disease
5. Severe co-morbid mental disorder causing major impairment of social functioning
Date of first enrolment01/01/2006
Date of final enrolment31/12/2008

Locations

Countries of recruitment

  • Germany

Study participating centre

Dept. of Psychosomatics
Munich
81675
Germany

Sponsor information

Munich Technical University (Germany)
University/education

University Hospital 'Rechts der Isar'
Munich Technical University
Ismaninger Str. 22
Munich
D-81675
Germany

Website http://www.med.tu-muenchen.de
ROR logo "ROR" https://ror.org/02kkvpp62

Funders

Funder type

Not defined

Sponsor Code: 1359/05

No information available

German Research Foundation (Deutsche Forschungsgemeinschaft [DFG])/German Federal Ministry of Education and Research (Bundesministerium Für Bildung und Forschung [BMBF]) Code: He 3200/4-1; 60665-02-2/167/04

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 01/06/1999 Yes No
Abstract results 01/04/2003 No No
Results article results 01/01/2012 Yes No