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Front. Psychiatry | doi: 10.3389/fpsyt.2018.00151

A European research agenda for Somatic Symptom Disorders, Bodily Distress Disorders, and Functional Disorders: Results of an estimate-talk-estimate Delphi expert study.

 Christina M. Van der Feltz-Cornelis1, 2*, Iman Elfeddali1, 2,  Ursula Werneke3,  Ulrik F. Malt4, 5, Omer Van den Bergh6,  Rainer Schaefert7, Willem J. Kop8, Antonio Lobo9, 10, Michael Sharpe11,  Wolfgang Söllner12,  Bernd Löwe13 and on behalf of EAPM14
  • 1Tranzo, Tilburg University, Netherlands
  • 2Clinical Centre of Excellence for Body Mind and Health, GGz Breburg, Netherlands
  • 3Department of Clinical Sciences, Divison of Psychiatry, Sunderby Research Unit, Umeå University, Sweden
  • 4Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Norway
  • 5Section for Psychosomatic Medicine, Division of Mental Health and Dependency, Oslo University Hospital, Norway
  • 6Health Psychology, KU Leuven, Belgium
  • 7Department of Psychosomatic Medicine, Universitätsspital Basel, Switzerland
  • 8Clinical and Medical Psychology, Tilburg University, Netherlands
  • 9Medicine and Psychiatry, University of Zaragoza, Spain
  • 10CIBERSAM, National Institute of Health Carlos III, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Spain
  • 11Saint Cross College, University of Oxford, United Kingdom
  • 12Department of Psychosomatic Medicine and Psychotherapy, Klinikum Nürnberg, Germany
  • 13Institut und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Germany
  • 14, European Association of Psychosomatic Medicine (EAPM), Germany

Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe.
Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective.
Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings.
Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioural pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation.

Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe.

Keywords: Somatic symptom disorder, Bodily distress disorder, functional disorders, Research agenda, Europe, Delphi study, expert survey, EAPM

Received: 23 Jan 2018; Accepted: 04 Apr 2018.

Edited by:

Michael Noll-Hussong, Universitätsklinikum des Saarlandes, Germany

Reviewed by:

Robert H. Howland, School of Medicine, University of Pittsburgh, United States
Jeffrey P. Staab, Mayo Clinic, United States  

Copyright: © 2018 Van der Feltz-Cornelis, Elfeddali, Werneke, Malt, Van den Bergh, Schaefert, Kop, Lobo, Sharpe, Söllner, Löwe and EAPM. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Christina M. Van der Feltz-Cornelis, Tilburg University, Tranzo, Warandelaan 2, Tilburg, Tilburg, Netherlands,