Emotional Disorder in Chronic Illness: Psychotherapeutic Interventions

Abstract

BackgroundEmotional disorder associated with physical illness falls into two main groups: ‘psychological reaction to physical illness’ and ‘somatic presentation of psychological disorder’. Psychological treatments are becoming more widespread in the general hospital setting, but there are few systematic evaluations.MethodA manual and computer (MEDLINE) literature search was performed. Studies which provided insight into clinical practice were selected for discussion, and randomised controlled trials of at least 6 weeks duration and inclusion of 30 or more subjects were selected for review.ResultsFourteen empirical studies were found: six involving patients with chronic organic disorder and eight involving patients with somatisation.ConclusionsThere is little empirical evidence that psychotherapeutic interventions are of benefit when applied indiscriminately to patients with organic disease. Further work is required to delineate subgroups of patients who may be responsive. There is mounting evidence that psychotherapy is beneficial in patients with somatisation disorders. Patients with very chronic symptoms may require intensive treatment approaches.