JMIR Publications

ABSTRACT

Background:

Somatic symptom disorder (SSD) is a mental disorder marked by persistent somatic symptoms and maladaptive health-related thoughts and behaviors. Cognitive behavioral therapy (CBT) has been shown to be effective in treating SSD, reducing patients’ physical symptoms, anxiety, and depression. However, challenges remain – including limited access to treatment . Videoconference-based CBT (vCBT) has emerged as a promising approach, offering flexible and tailored treatment while addressing the shortage of medical resources and reducing patient dropout.

Objective:

This study examined the feasibility of vCBT for patients with SSD and explored secondary outcomes related to the physical component of health-related quality of life (HRQOL; SF-36 PCS) and symptom severity.

Methods:

This pilot single-arm trial evaluated feasibility as the primary outcome, assessed via recruitment rate, retention rate, session completion rate, and safety. Ten patients with SSD were recruited, and all received six weekly 50-minute vCBT sessions. Secondary outcomes included physical HRQOL (key secondary outcome) as well as mental HRQOL, depressive symptoms, anxiety symptoms, health anxiety, pain, insomnia, and generic HRQOL. These outcomes were measured at pre-intervention (week 0), post-intervention (week 6), and follow-up (week 10), and were analyzed using paired t-tests.

Results:

All feasibility criteria were met, with a 100% session completion rate and no adverse events reported. Physical HRQOL (SF-36 PCS) improved by 4.99 points at post-intervention, representing a large effect (Cohen’s d = 0.99, 95% CI [0.21–1.74]). Medium to large improvements were also observed in mental HRQOL, health anxiety, depressive and anxiety symptoms, pain, insomnia, and generic HRQOL, and most of these gains were maintained at follow-up.

Conclusions:

Our findings indicate that vCBT is a feasible, acceptable, and safe approach for SSD, with preliminary evidence of effectiveness.