Mindfulness therapy for somatization disorder and functional somatic syndromes: analysis of economic consequences alongside a randomized trial.

OBJECTIVE: The objective of the present study is to estimate the economic consequences of somatization disorder and functional somatic syndromes such as fibromyalgia and chronic fatigue syndrome, defined as bodily distress syndrome (BDS), when mindfulness therapy is compared with enhanced treatment as usual.

METHODS: A total of 119 BDS patients were randomized to mindfulness therapy or enhanced treatment as usual and compared with 5950 matched controls. Register data were analyzed from 10years before their inclusion to 15-month follow-up. The main outcome measures were disability pension at the 15-month follow-up and a reduction in total health care costs. Unemployment and sickness benefit prior to inclusion were tested as possible risk factors.

RESULTS: At 15-month follow-up, 25% from the mindfulness therapy group received disability pension compared with 45% from the specialized treatment group (p=.025). The total health care utilization was reduced over time in both groups from the year before inclusion (mean $5325, median $2971) to the year after inclusion (mean $3644, median $1593) (p=.0001). This overall decline was seen in spite of elevated costs due to assessment and mindfulness therapy or enhanced treatment as usual. The BDS patients accumulated significantly more weeks of unemployment and sickness benefit 5 and 10years before inclusion (p<.0001) than the population controls.

CONCLUSIONS: Mindfulness therapy may prevent disability pension and it may have a potential to significantly reduce societal costs and increase the effectiveness of care. Accumulated weeks of unemployment and sickness benefit are possible risk factors for BDS.