Effectiveness of group cognitive behavioral therapy for somatoform pain disorder patients in Japan: A preliminary non‐case‐control study

Abstract

Aims: Somatoform pain disorder is associated with psychosocial dysfunction, and psychotherapies, such as cognitive behavioral therapy (CBT), are thought to provide useful interventions to address such dysfunction as well as the pain itself. However, little is known about whether CBT for somatoform pain disorder is effective, including the long-term course of the illness, in non-Western populations. We therefore tailored such a program based on an existing CBT protocol and examined its effectiveness in Japan.Methods: Thirty-four Japanese participants (22 women; mean age = 52.5 years) enrolled in a weekly 12-session group treatment, with 32 completing both wait-list and treatment conditions. The primary outcome measure was pain intensity. Secondary outcome measures included pain characteristics, as measured by pain catastrophizing and psychometric evaluations, including depression, anxiety, and quality of life. The patients were followed up for 12 months after treatment. Results:We found that pain intensity, anxiety, depressive symptoms, and social functioning all significantly improved after treatment compared with the wait-list period, and the improvements in pain intensity, depressive symptoms, and social functioning were sustained at 12 months following the completion of CBT. There were strong positive correlations (P < 0.01) among pre-and post-treatment changes in the affective dimension of pain, depression, anxiety, and pain catastrophizing. Conclusions:These results show that the present CBT program was effective for Japanese patients with somatoform pain disorder and that gains were maintained over the long term. More work is needed to further clarify the effects of CBT interventions on somatoform symptoms, particularly in Japan.

Changes in resting-state brain networks after cognitive–behavioral therapy for chronic pain

“…The theoretical model, rationale, and details of the CBT treatment have been previously described (Yoshino et al 2015). The major aims of treatment were to develop self-monitoring techniques that facilitate the identification of pain, thinking, behavior, and mood, to learn self-control techniques such as relaxation and behavioral activation, and to modify specific pain-related dysfunctional beliefs.…”

“…In terms of psychological interventions for chronic pain, cognitive-behavioral therapy (CBT) is reported to be useful, and is designed to modify maladaptive perceptual and behavioral patterns and to teach self-control techniques for pain management Yoshino et al 2015). However, to our knowledge, there are only a few neuroimaging studies that have investigated brain mechanisms modulated by CBT for patients with chronic pain.…”

Role of coping with negative emotions in cognitive behavioral therapy for persistent somatoform pain disorder: Is it more important than pain catastrophizing?

“…Patients with persistent somatoform pain disorder (PSPD) are often characterized by a tendency to experience somatic symptoms in response to psychosocial stress . The efficacy of cognitive behavioral therapy (CBT) for PSPD has been demonstrated across clinical trials . Various studies, including our own, have shown that pain catastrophizing has an influence on the effect of pain intensity and pain‐related disabilities during CBT for somatoform disorders .…”

“…The efficacy of cognitive behavioral therapy (CBT) for PSPD has been demonstrated across clinical trials . Various studies, including our own, have shown that pain catastrophizing has an influence on the effect of pain intensity and pain‐related disabilities during CBT for somatoform disorders . Pain catastrophizing is defined as the tendency to make an excessive broad interpretation of amplification and helplessness in the face of pain experience .…”

“…Therefore, it is important to assess each of these factors separately to clarify the pathophysiology and treatment mechanisms of PSPD. We have previously reported a preliminary study on the therapeutic efficacy of CBT for patients with PSPD . In the present study, we focused on the importance of pain catastrophizing and negative emotions during CBT for patients with PSPD as an exploratory post‐hoc analysis.…”