Unblinded trials with subjective outcome measures: I found quite a few unblinded trials which seemed to show that talk therapy benefited those diagnosed with SSD. If talk therapy really relieved the symptoms of SSD, this would indeed be evidence that the symptoms have psychological causes. However, while these trials did have control groups, the control groups received ‘treatment as usual,’ which amounts to no treatment at all. The patients knew which group they were in, and the experimental group received a treatment while the control group did not. We know that any group of patients who are given therapy of any type will report improvement; this is known as the therapy effect, similar to the placebo effect. Furthermore, these trials had subjective rather than objective outcome measures. In the trials I looked at the outcome measure was a survey. This is not ideal because people who have received a treatment often feel that they ‘should’ feel better; they almost feel obligated to say that they have improved. Combined with the lack of blinding, this amounts to a very poor study design. It reminds me of the deluge of poorly-designed clinical trials which for years seemed to show (wrongly) that ME/CFS could be treated with counseling and exercise.
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Extract from:
Somatic symptom disorder: Why your doctor doesn't believe you're really sick
mecfs.substack.com/p/somatic-sy...
#chronicillness #Spoonie #hiddenillness #invisibleillness
