Internet-Based CBT for Somatic Symptom Distress (iSOMA) in Emerging Adults: A Randomized Controlled Trial

Objective: Persistent somatic symptom distress is common in emerging adults and is associated with adverse health outcomes and impairment. Internet-based interventions could help to prevent burden and chronicity. This randomized controlled trial tested the efficacy of a guided, cognitive-behavioral internet intervention for somatic symptom distress (iSOMA) in emerging adults at risk for somatic symptom disorder compared to a waitlist control condition. Method: 158 participants (N = 156 analyzed; 24.53 years, 83.3% female) with multiple somatic symptoms were recruited among German-speaking universities and randomly allocated to either receive the 8-week iSOMA intervention with psychologist support or the waitlist, both with access to treatment as usual. Primary outcomes were somatic symptom distress Patient Health Questionnaire, somatic symptom scale (PHQ-15) and psychobehavioral features of somatic symptom disorder-12 (SSD-12), assessed at baseline and 8-weeks postrandomization. Secondary outcomes included depression, anxiety, illness worries, functional impairment, and attitudes toward psychological treatment. Results: Participants in the iSOMA group showed significantly greater improvements ( ps <.001) in primary outcomes (PHQ-15: d=0.70 [0.36, 1.05], SSD-12: d=0.65 [0.30, 0.99], and secondary outcomes ( ps<.05; d = 0.41–0.52) compared to the waitlist, except for attitudes toward psychological treatment (p =.944). Satisfaction with iSOMA was high (91.0%), most participants (72.8%) completed at least 4 of 7 modules and negative treatment effects were infrequent (14.9%).