Randomised controlled trial of disclosure of emotionally important events in somatisation in primary care

Objective To test whether a disclosure intervention improves subjective hea lth and reduces medical consumption and sick leave in somatising patients i n general practice. Design Non-blind randomised controlled trial. Setting 10 general practices in the Netherlands. Participants 161 patients who frequently attended general practice with som atising symptoms. Intervention Patients in the intervention group were visited two to three t imes and invited to disclose emotionally important events in their life. Co ntrol patients received normal care from their general practitioners. Main outcome measures Use of medical services (drugs and healthcare visits) , subjective health, and sick leave assessed by self completion questionnai res after 6, 12, and 24 months. Results Of the 161 patients, 137 completed the trial (85%). Both groups wer e comparable at baseline. The intervention had no effect on the main outcom e measures at any point. Intervention patients made one more visit to healt h care (95% confidence interval - 4 to 6): the use of medicines did not cha nge in both groups(- 1 to 1); subjective health improved 3.6 points more in the control group (- 11.2 to 4.3); and disclosure patients were oil sick l eave one more week (- 1 to 3). Patients often had a depression or anxiety d isorder for which they were not receiving adequate care. Conclusion Although the intervention was well received by patients and doct ors, disclosure had no effect on the health of somatising patients in gener al practice.