Effectiveness of a multimodal treatment program for somatoform pain disorder

Pain Pract. 2014 Mar;14(3):E146-51. doi: 10.1111/papr.12144. Epub 2013 Dec 4.

Abstract

Chronic pain conditions are highly prevalent, with somatoform pain disorder accounting for a large proportion. However, the psychological forms of treatment currently used achieve only small to medium effect sizes. This retrospective study investigated the effectiveness of a 5-week multimodal pain program for patients with somatoform pain disorder. The diagnosis of somatoform pain disorder was confirmed by a specialist for anesthesiology and pain management and a specialist for psychosomatic medicine. Therapy outcome was evaluated with a Numeric Rating Scale (NRS), the Pain Disability Index (PDI), and the Pain Perception Scale. Within the study sample (n = 100), all parameters showed a significant and clinically relevant improvement at the end of therapy (P values < 0.001). The highest effect sizes (d) were found for reduction in average pain rating (NRS: d = 1.00) and the affective items of the Pain Perception Scale (SES-A: d = 0.07). The lowest effect sizes were found for improvement of pain-related disabilities (PDI: d = 0.42) and sensory items of the Pain Perception Scale (SES-S: d = 0.50). Despite high chronification of pain condition, with average pain duration of greater than 8 years, the multimodal treatment program showed medium to large effect sizes on the outcome of patients with somatoform pain disorder. Compared with previous data with small to moderate effect sizes, a multimodal program seems to be more effective than other interventions to address somatoform pain disorder.

Keywords: cognitive behavioral therapy; medically unexplained symptoms; multimodal treatment; somatic symptom disorder; somatoform disorder.

MeSH terms

  • Adult
  • Analgesics / therapeutic use*
  • Combined Modality Therapy
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain
  • Pain Management*
  • Pain Measurement
  • Psychotherapy / methods*
  • Quality of Life*
  • Retrospective Studies
  • Somatoform Disorders / drug therapy
  • Somatoform Disorders / psychology
  • Somatoform Disorders / therapy*
  • Treatment Outcome

Substances

  • Analgesics