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Clinical importance of systematic assessment and psychoeducation in specialised treatment of adolescents with severe functional somatic disorders

Published online by Cambridge University Press:  01 September 2022

K. Kallesøe ,
A. Schröder ,
R. Wicksell  and
C. Rask
K. Kallesøe*
Affiliation:
Psychiatry, Aarhus University Hospital, Research Unit, Department Of Child And Adolescent Psychiatry, Aarhus N, Denmark
A. Schröder
Affiliation:
Aarhus University Hospital, Research Clinic For Functional Disorders And Psychosomatics, Aarhus C, Denmark
R. Wicksell
Affiliation:
Karolinska Institutet, Department Of Clinical Neuroscience, Solna, Sweden
C. Rask
Affiliation:
Psychiatry, Aarhus University Hospital, Research Unit, Department Of Child And Adolescent Psychiatry, Aarhus N, Denmark Aarhus University, Department Of Clinical Medicine, Aarhus C, Denmark
*
*Corresponding author.

Abstract

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Introduction

Functional somatic disorders (FSD) characterized by persistent and disabling physical symptoms are common in youth. Diagnostic uncertainty and insufficient illness explanations are proposed as perpetuating factors for FSD and may furthermore serve as barriers for treatment engagement.

Objectives

The present study is part of a larger randomized trial and aimed at evaluating the impact of systematic assessment and psychoeducation on various clinical outcomes for adolescents suffering from severe FSD.

Methods

Ninety-one adolescents (15-19 years) with severe FSD of at least 1 year’s duration were included in the randomized trial AHEAD (Acceptance and Commitment Therapy for Health in Adolescents). All participants received a thorough assessment (approximately 4 hrs.) and a subsequent psychiatric consultation (1.5 hrs) focusing on further psychoeducation and health promoting strategies. Clinical outcomes included self-reported physical health (SF-36), symptom severity, illness perception, illness related behaviour and psychological flexibility. Questionnaires were distributed at baseline (before assessment) and 2 months after randomisation. Data were analysed using simple t-tests.

Results

Assessment and psychiatric consultation were not associated with a clinically relevant improvement of physical health, mean difference 0.23 95% CI [-0.95;1.41] p=0.701. However, a considerate decline was seen on symptom severity (p=0.017), illness worry (p<0.001) and negative illness perceptions (p<0.001). Furthermore, a decline was seen in limiting illness behaviour (p=0.002) and psychological inflexibility (p=0.001).

Conclusions

The results underpin the importance and the potential positive implications of thorough assessment and psychoeducation. Hence, these elements may be in their own right in the systematic and specialised treatment of adolescents with severe FSD.

Disclosure

No significant relationships.

Keywords

functional somatic disorderspsychoeducation
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S143
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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