[Experiential acceptance in the treatment of complex somatic symptom disorder]. / Ervaringsgerichte acceptatie bij de behandeling van complexe somatisch-symptoomstoornis.

BACKGROUND: Acceptance and Commitment Therapy (ACT) plays an important role in the treatment of patients with refractory Somatic Symptom Disorder and related disorders with complex problems and/or somatic or psychiatric comorbidity (complex SSD). AIM: To gain insight into the possible role of (experiential) acceptance in improved quality of life during and after treatment. METHOD: Observational longitudinal study in 41 patients with complex SSD treated at Altrecht Psychosomatic Medicine Eikenboom. They completed online questionnaires around the start and completion of treatment and after six months of follow-up. Assessed were experiential acceptance (AAQ-II-NL) and three aspects of quality of life (RAND-36: mental health, physical functioning, general health perception). The associations between changes in acceptance and quality of life were determined. RESULTS: Acceptance increased significantly from treatment initiation to follow-up. Mental health increased significantly between start and end of treatment, and general health perception increased significantly in the follow-up period. Physical functioning did not change. During treatment, an increase in acceptance was significantly associated with improvement in mental health and general health perception; during follow-up, an increase in acceptance was associated with an improvement in mental health. CONCLUSION: The current study demonstrates that an increase in experiential acceptance goes hand in hand with an improvement in mental health and general health perception. These results indicate the potential importance of acceptance-based treatment in patients with complex SSD. Experimental research with more frequent measurements is needed to test a temporal relationship between (first) increased acceptance and (then) improved quality of life.

[Body-oriented mentalization based therapy in severe somatic symptom disorder]. / Lichaamsgerichte mentalisatiebevorderende therapie bij patiënten met een somatisch-symptoomstoornis.

BACKGROUND: Body-oriented mentalization based therapy (L-MBT) is used in specialist mental health care for the treatment of patients with somatic symptom disorder or functional neurological disorder. L-MBT focuses on increasing awareness of bodily sensations and integrating them with psychological functions such as thinking, feeling or remembering. The goal of L-MBT is that patients with somatic symptom disorders learn to mentalize their body signals and the associated inner experiences. There are favorable experiences in clinical practice, but to date the mechanism of change and the effectiveness of treatment with L-MBT has not yet been sufficiently scientifically demonstrated. AIM: To investigate whether patients with severe somatic symptom disorders improve their body awareness and mentalizing capacity during an intensive treatment program based on L-MBT. METHOD: Body awareness and mentalizing capacity were assessed in patients following intensive treatment at Altrecht Psychosomatics Eikenboom, a highly specialized treatment center for adults with a severe somatic symptom disorder or functional neurological disorder Patients’ body awareness was assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA-2), mentalizing capacity with the Mentalization Questionnaire (MZQ). Questionnaires were filled in at the start, halfway and at the end of treatment. RESULTS: Both body awareness and mentalizing ability improved significantly during the intensive L-MBT-based treatment with generally a large effect size. CONCLUSION: During an intensive treatment program based on L-MBT, there is an increase in body awareness and mentalizing capacity in patients diagnosed with a severe somatic symptom disorder.