Contrasting two improved and two unimproved cases of patients with medically unexplained physical symptoms after multicomponent treatment

ABSTRACT

Objective: While some patients suffering from medically unexplained physical symptoms (MUPS) benefit from psychological treatment, others do not. The aim of this study was to analyse both quantitative and qualitative data of four patients with MUPS (two improvers and two nonimprovers) after multicomponent treatment to find an explanation for the outcome differences. Method: Two improvers and two nonimprovers were contrasted within the explanatory sequential mixed method design. Quantitative prepost data from multiple outcome measures were combined with semistructured interviews. Findings: The analysis revealed two key processes that differentiated improvers from nonimprovers: (1) implementing lifestyle changes and (2) receiving environmental support. Furthermore, interoceptive awareness and emotional regulation may be two other important processes seen in quantitative data but not identified by patients. Conclusion: The findings of this study offer an understanding of the different impacts of selected change mechanisms in patients with MUPS, which may help clinicians deliberately aim to focus on important areas of treatment.

KEYWORDS:

• Medically unexplained physical symptoms
• multicomponent treatment
• patients’ experience
• chronic illness
• psychosomatics

Disclosure statement

No potential conflict of interest was reported by the author(s).

Practical implications

Findings from this study bring new insights into the topic of effective treatment of patients with medically unexplained physical symptoms (MUPS). Health care providers can look at mechanisms of change that seem to be important for a successful treatment, which are described as four case studies (two improvers and two nonimprovers). Based on these new understandings, the health care providers can choose the best treatment option for patients with MUPS.

Data availability statement

The data supporting this study’s findings are available on request from the corresponding author, Lucia Polakovská. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Additional information

Funding

This work was supported by the Czech Science Foundation under Grant GA18-08512S; and the Specific University Research provided by the Czech Ministry of Education, Youth, and Sports under Grant MUNI/A/1216/2020.