Patients presenting with multiple unexplained physical symptoms such as somatization disorder (SD) and abridged somatization (AS) pose significant challenges in mental health and primary care settings. Until recently, no intervention had been found to produce meaningful improvement in these patients. We present here results of two studies one on SD the other on AS.

Study 1 included 84 patients with SD seen in a mental health setting and Study 2, 172 patients with AS seen in primary care. In both studies, patients were randomly assigned to either a “standard care” or an “experimental treatment” consisting of a 10 session CBT designed for patients with unexplained symptoms. The Clinical Global Scale (CGI) for Somatic Symptoms was the key outcome measure.

In Study 1, CBT-treated SD patients were significantly more likely to be rated as “much/very much improved” than “control” patients (39.5% vs. 4.9%). CBT also led to a decrease in health care costs. In Study 2, CBT-treated AS patients were significantly more likely to be rated more “much/very much improved” in the CGI than those in the control group (60% vs. 25.8%). Depressive symptoms also improved more under CBT but the effect on physical symptoms was independent from that on depression.

For patients diagnosed with SD and AS in primary and specialty care, CBT produced clinical benefits beyond those that result from current state of the art treatments. CBT may be the treatment of choice for most of these patients.