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What psychological interventions are effective for the management of Persistent Physical Symptoms (PPS)? A systematic review and meta-analysis

Lookup NU author(s): Dr Kate SwainstonORCiD, Lorelle Dismore



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


ObjectivesPresentation of persistent physical symptoms (PPS) is associated with increased health care utilisation, yet clinical outcomes often remain suboptimal. This systematic review aimed to determine whether psychological interventions are effective for the management of PPS and if so, what are the features of the interventions and at what level of care are they delivered. The review also set out to establish which symptoms in those diagnosed with PPS can be effectively managed with psychological intervention. MethodsStudies were included if they clearly reported a psychological intervention, specified the study sample as adults with a diagnosis of persistent physical symptoms, included a comparator, and as a minimum an outcome measure of somatic symptoms. Risk of bias was assessed using the EPHPP. Meta-analysis was conducted to estimate the overall effect of interventions on somatic symptoms (the primary outcome), anxiety and depression (secondary outcomes). ResultsSeventeen papers of varying quality indicated that psychological interventions can be effective for the management of somatic symptoms reported by individuals with PPS within a primary care setting. Psychological interventions were also found to be effective at reducing depression symptoms in individuals with PPS in twelve of the included studies. However, the meta-analysis results suggest that the psychological interventions utilised within eleven of the included studies did not significantly impact anxiety symptoms. ConclusionsPsychological interventions have some success in managing somatic symptoms in PPS patients within primary care settings although their effects on other psychological symptoms is more mixed. The review highlights the importance of establishing a clearer diagnostic classification to inform treatment trajectories and the need for appropriate training and support within a multi-disciplinary team to enable the provision of such therapies.

Publication metadata

Author(s): Swainston K, Thursby S, Bell B, Poulter H, Dismore L, Copping L

Publication type: Article

Publication status: Published

Journal: British Journal of Health Psychology

Year: 2023

Volume: 28

Issue: 1

Pages: 80-97

Print publication date: 01/02/2023

Online publication date: 15/07/2022

Acceptance date: 17/06/2022

Date deposited: 12/07/2022

ISSN (print): 1359-107X

ISSN (electronic): 2044-8287

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/bjhp.12613


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