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A Randomized Cross-over Trial Comparing Life Stress Interview versus Basic Assessment of Psychiatric Symptoms for Patients with Persistent Physical Symptoms.

D. Maroti,Malin Ljungdahl,Helena Petersen,Mattias Rööst,F. Falkenström,P. Lilliengren

Published 2025 in Biopsychosocial science and medicine

ABSTRACT

OBJECTIVE This randomized cross-over trial aimed to compare the effects of a one-session emotion-focused intervention, the Life Stress Interview (LSI), with a Basic Assessment of psychiatric Symptoms (BAS) condition for patients with Persistent Physical Symptoms (PPS). METHODS One-hundred and eighty-nine participants (n=189), predominantly middle-aged females with high psychiatric comorbidity and persistent somatic symptoms, were randomly assigned to receive both LSI and BAS in varying order. Symptom change over time and interaction effects were analyzed using linear mixed models. RESULTS Both conditions led to significant reductions in somatic symptoms (PHQ-15; B=-0.51, 95% CI [-0.76, -0.26]) and psychiatric distress over time, but no significant differences between LSI and BAS were observed. However, significant Sequence x Treatment interaction effects indicated that administering LSI first rather than second resulted in a steeper decline in somatic symptoms (PHQ-15: B=0.57, 95% CI [0.15, 1.00]) and post-traumatic symptoms (PCL-5: B=1.85, 95% CI [0.05, 3.64]), whereas the timing of BAS had little effect on outcome. CONCLUSION Our finding that the LSI does not yield more symptom reduction in patients with PPS than a comparison diagnostic interview raises questions about the LSI's unique value, although the observed sequence effect suggests that the LSI may enhance symptom improvement when followed by a psychiatric assessment. Moreover, both brief interventions appear to contribute to symptom reduction. A limitation is that prior psychotherapy experience may have reduced the LSI's impact, and emotional processing during interviews was not assessed. Further research should explore how LSI can be integrated with other interventions to meet the diverse needs of patients with PPS.

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