Evidence-based treatment

This chapter aims to provide an overview of the current state of evidence regarding treatment of medically unexplained symptoms, somatisation and the functional somatic syndromes. We first describe the heterogeneity of the settings and types of treatment that have been used in a wide variety of disorders. The existing evidence is then examined against this background. The data are arranged using the groups of patients described in and we concentrate on recent systematic reviews where possible. The section on functional somatic symptoms focuses on psychological treatments and antidepressants only; it does not include the numerous symptomatic treatments that are available for these syndromes; they have been reviewed elsewhere [1]. The chapter concludes with a section concerning the commonalities of treatment across all of these disorders, with a view to identifying common, effective ingredients of treatments to indicate how services for these patients may be improved. The chapter does not include a review of the evidence for efficacy of treatment for conversion disorder as the evidence base is so inadequate [2;3].