Improving mental health through body-awareness with dynamic interpersonal therapy in patients with persistent somatic symptoms: an explorative cohort study.

Introduction: This study explored the changes in mental health and body-awareness in patients with severe persistent somatic symptoms (PSS) treated with multidisciplinary Dynamic Interpersonal Therapy. Methods: In this longitudinal study 56 patients with severe somatic-symptom disorder (DSM-5) were included. Analyses were conducted on available outcome data from 32-38 patients. All were treated with a multidisciplinary DIT program for 6 months in a specialized care facility. Patients were followed up during treatment with the questionnaires Mental Health Continuum Short Form (MHC-SF) and Multidimensional Assessment of Interoceptive Awareness (MAIA) at baseline, 3 months and 6 months. Change was analysed with repeated measures ANOVA. The association between change in MAIA and change in MHC-SF was explored with linear regression analysis. Results: Both mental health (MHC-SF total score 28 to 33, p<0.001) and interoceptive awareness (MAIA score 88 to 92 p=0.045) increased after treatment. The improvement was mostly seen in the psychological and social wellbeing subscales of the MHC-SF and the self-regulation and body listening subscales of the MAIA. A higher pre- to post-treatment change on the MAIA was associated with a higher change on the MHC-SF (R2 = 0.352, B = 1.464, p < 0.001). Conclusions: This study shows that patients with PSS 1 have lower mental health scores relative to general population norm, 2) seem to have reduced capacity for interoceptive awareness 3) improve in both areas after completing DIT for PSS and 4) shows that improvement in interoceptive awareness was associated with improvement in mental health. Interoception based interventions in DIT-PSS might be a starting point for adequate treatment of PSS.