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Flexible Coping Psychotherapy for Functional Dyspeptic Patients: A Randomized, Controlled Trial

From the Department of Psychology, The University of Hong Kong, Hong Kong (C.C.); the Institute of Basic Medicine, Capital University of Medical Sciences, Beijing, China (F.Y., S.J.); and South London and Maudsley NHS Trust, London, United Kingdom (J.M.H).

Address correspondence and reprint requests to Cecilia Cheng, PhD, Department of Psychology, The University of Hong Kong, Pokfulam Road, Hong Kong. E-mail: ceci-cheng{at}hku.hk

Objective: This study tested the efficacy of a new psychotherapy, flexible coping psychotherapy (FCP), specifically designed for enhancing coping flexibility of patients with functional dyspepsia (FD). The design of this psychotherapy is based on the general cognitive–behavioral model and previous findings on FD.

Methods: We adopted a randomized, controlled design to examine the differences between the target (FCP) and control (supportive psychotherapy [SPP]) conditions. Coping flexibility and outcome measures reported by 75 Chinese FD patients (18–65 years; 35% men) were assessed before and 12 months after treatment.

Results: Results revealed that participants who received the FCP reported an increase in coping flexibility as well as reductions in self-rated dyspeptic symptom severity (SDSS), gastroenterologist-rated dyspeptic symptom severity, and anxiety levels (p values <.01). Participants who received the SPP reported reductions in SDSS and anxiety levels (p values <.0001). Although both groups reported a decrease in SDSS, only the SDSS level of the FCP group was comparable to that of a healthy community sample (p = .28).

Conclusions: These findings suggest that FCP is a potentially effective intervention for treating FD symptoms. Its effectiveness may be attributable to the specific components of FCP rather than common psychotherapeutic factors such as emotional support and empathy per se.

Key Words: anxiety • coping • functional dyspepsia • psychotherapy • randomized controlled trial • stress

Abbreviations: CFQ = Cognitive Flexibility Questionnaire; DSQ = Dyspeptic Symptom Questionnaire; FCP = flexible coping psychotherapy; FD = functional dyspepsia; GDSS = gastroenterologist-rated dyspeptic symptom severity; MANOVA = multivariate analysis of variance; RCI = reliable change index; SDSS = self-rated dyspeptic symptom severity; SPP = supportive psychotherapy; STAI = State-Trait Anxiety Inventory.