Personalized treatment outcomes in patients with somatoform disorder: a concept mapping study

Abstract

Objective From a patient-centered perspective, treatment outcome measures in somatoform disorder need to be (1) personalized to the patient, (2) fit core problems that are targeted in therapy, and (3) reflect one's ability to adapt and self-manage anticipated deterioration. The aim of this study was to identify an encompassing set of treatment outcome variables in patients with somatoform disorder. Methods In-depth interviews yielded a comprehensive overview of 60 treatment outcomes that were sorted in a card sorting task according to similarity of meaning by 30 patients. Hierarchical cluster analysis (squared Euclidean distances, Ward's method) was used to obtain a structured overview of treatment outcomes unbiased by subjective interpretations of researchers. Perceived importance and personal change were examined using descriptive statistics. Results The hierarchical structure of treatment outcomes showed seven clusters, classified in two broad categories: self-other relationships (comprising social support, health care use, and self-confidence) and self-management (comprising physical balance, psychological adjustment, symptom acceptance, and resilience). Ratings of the importance of the clusters showed large individual differences. Most participants retrospectively perceived positive personal change. Conclusion The wide variety of treatment outcomes and the observation that patients attach different importance to the outcome measures supports the value of developing new personalized outcome measures for effect studies. In clinical practice, the clusters of outcomes can be used in shared decision making during intake, to define treatment goals, and to map and evaluate change on a personalized set of outcome measures.