Changed dynamic symptom networks after a self-compassion training in patients with somatic symptom disorder: A multiple single-case pilot project.

OBJECTIVE: Pre-to-post mean group differences of intermittently assessed generic outcome variables may not capture all relevant treatment-related changes in individual patients with somatic symptom disorder (SSD). Aim of this multiple single-case observational pilot project was to find out whether the Experience Sampling Method (ESM) and dynamic symptom networks may offer new opportunities in evaluating treatment outcomes for individual patients with SSD. METHODS: Patients with SSD (N = 6 in study 1, N = 7 in study 2) received a self-compassion training in a tertiary care mental health expert center. Using a single-case pre-post treatment observational design, intensive longitudinal data were collected with ESM. A brief questionnaire was presented via the patient's smartphone three times per day for 16 weeks before, during and after the training in study 1, and for 5 weeks before and 5 weeks after the training in study 2. Eleven questions comprised somatic symptoms, functional disability, stress, self-compassion, and acceptance of affect; three personalized questions comprised self-chosen affects and an additional symptom. RESULTS: Sufficient observations for means and network comparison were obtained for 11 and 10 patients, respectively. After the training, self-compassion was significantly increased in 10 patients, functional disability, stress and affect improved in 6 patients, and (although not a treatment goal) somatic symptoms decreased in 6 patients. Dynamic symptom networks significantly changed in 5 patients. CONCLUSION: Patient-specific changes in means and dynamic symptom networks were observed after self-compassion training. In future clinical trials, single-case ESM may offer new opportunities to evaluate treatment outcomes in patients with SSD.

Self-compassion in somatoform disorder.

'Third wave' cognitive-behavioral therapies have given a boost to the study of resilience factors, such as self-compassion. To get an indication of the potential clinical relevance of self-compassion for somatoform disorder, this study examined whether self-compassion in patients with somatoform disorder is lower than in the general population, and whether self-compassion is associated with number of symptoms and health-related quality of life. Two-hundred-and-thirty-six participants with somatoform disorder and 236 subjects from the general population, matched on sex and age, filled out questionnaires regarding self-compassion (SCS), number of symptoms (PSC) and health-related quality of life (EQ-5D). The difference in self-compassion between the patient group (Mean 3.53, SD .96) and the general population (Mean 4.16, SD .98) was significant with a medium effect size (d = -.65). Multiple regression analyses showed that having a somatoform disorder and low self-compassion were independently associated with number of symptoms and reduced health-related quality of life. The lower level of self-compassion in somatoform disorder and its association with more physical symptoms and lower health-related quality of life, indicate that self-compassion is a potential clinically relevant factor that may influence therapy outcome and that can be a therapeutic target in patients with somatoform disorder.