{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:02:20Z","timestamp":1784091740378,"version":"3.55.0"},"reference-count":8,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychother Psychosom"],"abstract":"<jats:p>Introduction: Somatic symptom disorder (SSD) is associated with substantial impairment and high healthcare use, particularly among patients with chronic symptoms, psychiatric comorbidity, and poor response to standard interventions. Intensive short-term dynamic psychotherapy (ISTDP) is a promising emotion-focused approach, but evidence in treatment-resistant SSD remains limited. Methods: In this interrupted time-series study, 25 SSD patients who showed no improvement across two empirically supported online interventions in the preceding project year received up to 16 sessions (M = 14.1) of online ISTDP. Piecewise multilevel modeling compared PHQ-15 trajectories across 60 weeks before and 21 weeks after start of ISTDP. Secondary measures (PHQ-9, GAD-7, PCL-5, DERS-16) were administered pre-, post-, and at 12-week follow-up. Results: PHQ-15 trajectories were stable or slightly worsening during the pretreatment year but declined significantly after ISTDP began, corresponding to a large estimated slope difference (d = 1.08) at the end of the treatment phase. Among completers (n = 22), 59% achieved minimal clinically meaningful improvement (\u22653 PHQ-15 points), 27% showed \u226530% reduction, and 14% met recovery criteria. Secondary outcomes showed significant pre-post improvements in depression (d = 0.68) and anxiety (d = 0.42), while trauma symptoms and emotion regulation showed small, non-significant changes (d \u2264 0.30). Gains were largely maintained at 12-week follow-up. Emotional responses to treatment were common, but serious adverse events rare and dropout low. Conclusions: Online ISTDP appears feasible and effective for SSD patients who do not benefit from lower intensity interventions and may represent a useful next step in stepped-care pathways for complex, treatment-resistant presentations.<\/jats:p>","DOI":"10.1159\/000550629","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T17:01:01Z","timestamp":1772470861000},"page":"1-6","source":"Crossref","is-referenced-by-count":2,"title":["Online Intensive Short-Term Dynamic Psychotherapy for Treatment-Resistant Somatic Symptom Disorder: An Interrupted Time-Series Study"],"prefix":"10.1159","author":[{"given":"Peter","family":"Lilliengren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Ljungdahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"R\u00f6\u00f6st","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2486-6859","authenticated-orcid":false,"given":"Fredrik","family":"Falkenstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0587-1035","authenticated-orcid":false,"given":"Joel M.","family":"Town","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Maroti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721004177"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2025.112073"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1159\/000484413"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011142.pub2"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.12.096"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1159\/000540161"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1159\/000507738"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2024.111889"}],"container-title":["Psychotherapy and Psychosomatics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000550629","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:00:48Z","timestamp":1773853248000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000550629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":8,"URL":"https:\/\/doi.org\/10.1159\/000550629","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.31436017","asserted-by":"subject"}]},"ISSN":["0033-3190","1423-0348"],"issn-type":[{"value":"0033-3190","type":"print"},{"value":"1423-0348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,2]]}}}