4.2 Article

Significant Improvement of Somatic Symptom Disorder With Brief Psychoeducational Intervention by PMHNP in Primary Care

Journal

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/1078390320960524

Keywords

psychoeducation; chronic illness in primary care; motivational interviewing; Diagnostic and Statistical Manual of Mental Disorders(DSM); neurological pathways; visual analogue scale

Funding

  1. Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)

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This study provides an effective intervention for patients with somatic symptom disorders (SSD) and measures its effectiveness on their somatic symptoms. The intervention includes psychoeducation on brain pathways for pain and the body's response to stress, as well as the benefits of exercise and healthy diet. The results show significant symptom improvement immediately after the intervention, with sustained improvement three weeks post-intervention.
Background: Patients with somatic symptom disorders (SSD) are prevalent in primary care, urgent care, and emergency rooms and present with reduced quality of life, increased disability, and suicidality . Criteria for SSD include (1) somatic symptoms that cause distress and disrupt life; (2) concurrent physical illness with thoughts and feelings that are disproportionate to the seriousness of the illness; and (3) distress which is persistent and causes suffering. The frequency of SSD in the general population is 5% to 7%; however, in primary care, it is 5% to 35% . Because patients present with anxiety, depression, and/or pain, providers are flummoxed when diagnostic findings do not match symptom intensity. Aims: The purpose of this project was to provide an intervention for patients with SSD and measure its effectiveness on their somatic symptoms. Method: This study provided a single-session, 30-minute psychoeducational intervention for patients to explain brain pathways for pain and the body's response to stress, including scientific benefits of exercise and healthy diet. Patients were asked questions using the motivational interviewing technique OARS (open-ended question, affirmation, reflection, summary) and were encouraged to talk about their concerns. The study used a pre- and post-intervention visual analogue scale and a self-reported Patient Health Questionnaire-15 both before and 3 weeks post-intervention. Results: Measurements showed significant symptom improvement immediately after the intervention with sustained improvement 3 weeks post-intervention. Conclusions: This intervention demonstrates an effective treatment for this insidious illness, which plagues up to 35% of patients in primary care.

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