Project Details


DESCRIPTION (Applicant's Abstract): Somatizing patients -- those presenting to
physicians with multiple medically unexplained physical complaints - constitute
an important and vexing problem for the primary health care system. Patients
with this syndrome use health care resources extensively but receive little
benefit. In addition, these patients experience significant distress and
disability. To date, no medical or psychiatric intervention has been
demonstrated in controlled trials, to produce clinically significant and
lasting symptom relief or improved functional status in these patients.

We propose herein a randomized controlled trial (N=240) of cognitive behavior
therapy (CBT) versus medical care-as-usual for primary care patients with high
levels of medically unexplained somatic symptoms (patients who meet DSM-IV
criteria for a Somatoform Disorder as well as 'minimum symptom thresholds for
Escobar's "abridged somatization"). The intervention will take place at primary
care sites as somatizers are often reluctant to use psychiatric services or
even admit to psychiatric problems. In proposing this research, we are
encouraged by the positive results of several uncontrolled trials of CBT for
somatization, including a pilot test of our own manualized intervention.

A secondary aim of the proposed work is to examine the effectiveness of the CBT
protocol for a Latino sample, because high levels of unexplained physical
symptoms are quite prominent in many subgroups of Latinos. Moreover, Latinos
are the fastest growing minority population in the U.S., and are projected to
account for 24.5% of the total U.S. population by the year 2050, from 10.5%
currently (Bureau of the Census, 1996). In spite of the relatively high
prevalence of somatization in this group, to our knowledge, there are no
controlled trials of the effectiveness of treatments for somatization in the
Latino community.
Effective start/end date2/1/011/31/06


  • National Institute of Mental Health: $24,549.00
  • National Institute of Mental Health: $420,187.00
  • National Institute of Mental Health: $353,250.00


  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Neuroscience(all)


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