TY - JOUR
AU - M. Prieto-Vila
AU - G. Esteller-Collado
AU - C. González-Blanch
AU - R. Saunders
AU - J. E. J. Buckman
AU - M. Carpallo-González
AU - P. Ruiz-Rodríguez
AU - J. A. Moriana
AU - A. Cano-Vindel
AU - R. Muñoz-Navarro
A1 - 
AB - BACKGROUND: The course of persistent physical symptoms (PPS) is heterogeneous, yet little is known about distinct symptom trajectories and their baseline predictors across treatment conditions in primary care. This study aimed to identify PPS trajectories and their associated baseline characteristics in patients receiving treatment as usual (TAU) or transdiagnostic group cognitive behavioral therapy (TDG-CBT). METHODS: Latent Class Growth Analysis (LCGA) was used to identify trajectories of PPS (PHQ-15) over 12 months in 497 participants from the PsicAP randomized clinical trial (TAU: n = 242; TDG-CBT: n = 255). Baseline predictors of trajectory membership were examined using multinomial logistic regression. RESULTS: Three trajectories were identified within each treatment group: recovery, moderate chronic, and severe chronic. Recovery (class 1) was more frequent in TDG-CBT (54.9%) than in TAU (28.9%), whereas moderate chronic (class 2) and severe chronic (class 3) were more common in TAU (class 2 = 49.2%, class 3 = 21.9%) than in TDG-CBT (class 2 = 32.6%, class 3 = 12.6%). In TAU, chronic trajectories were associated with being female, having a partner, and higher baseline depressive symptoms. In TDG-CBT, chronic trajectories were associated with not having a partner, lower income, higher depressive and panic symptoms, and antidepressant use. CONCLUSIONS: TDG-CBT nearly doubles the likelihood of recovery and reduces chronic symptom trajectories compared with TAU. Baseline clinical severity and socioeconomic vulnerability may help identify patients at risk of chronic symptom courses and guide more tailored treatment strategies.
AD - Department of Personality, Assessment, and Psychological Treatment. Faculty of Psychology. University of Valencia. Valencia, Spain. Electronic address: maider.prieto@uv.es.; Department of Personality, Assessment, and Psychological Treatment. Faculty of Psychology. University of Valencia. Valencia, Spain.; "Marqués de Valdecilla" University Hospital - IDIVAL. Santander, Cantabria, Spain; Department of Psychology, International University of La Rioja (UNIR), Logroño, Spain.; CORE Data Lab, Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology. University College London. London, United Kingdom.; CORE Data Lab, Centre for Outcomes and Research Effectiveness, Research Department of Clinical, Educational and Health Psychology. University College London. London, United Kingdom; iCope - Camden and Islington NHS Talking Therapies for anxiety and depression Services. North London NHS Foundation Trust. London, United Kingdom.; Faculty of Biomedical and Health Sciences, Department of Psychology, Universidad Europea de Madrid, Spain.; Madrid Health Service. Tres Cantos. Madrid, Spain.; Department of Psychology. University of Córdoba. Córdoba, Spain; Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Spain; University Hospital of Reina Sofía, Spain.; Department of Experimental Psychology, Cognitive Processes and Logopedics, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
AN - 42001558
BT - J Psychosom Res
C5 - Medically Unexplained Symptoms
DA - Aug
DO - 10.1016/j.jpsychores.2026.112652
DP - NLM
ET - 20260327
JF - J Psychosom Res
LA - eng
N2 - BACKGROUND: The course of persistent physical symptoms (PPS) is heterogeneous, yet little is known about distinct symptom trajectories and their baseline predictors across treatment conditions in primary care. This study aimed to identify PPS trajectories and their associated baseline characteristics in patients receiving treatment as usual (TAU) or transdiagnostic group cognitive behavioral therapy (TDG-CBT). METHODS: Latent Class Growth Analysis (LCGA) was used to identify trajectories of PPS (PHQ-15) over 12 months in 497 participants from the PsicAP randomized clinical trial (TAU: n = 242; TDG-CBT: n = 255). Baseline predictors of trajectory membership were examined using multinomial logistic regression. RESULTS: Three trajectories were identified within each treatment group: recovery, moderate chronic, and severe chronic. Recovery (class 1) was more frequent in TDG-CBT (54.9%) than in TAU (28.9%), whereas moderate chronic (class 2) and severe chronic (class 3) were more common in TAU (class 2 = 49.2%, class 3 = 21.9%) than in TDG-CBT (class 2 = 32.6%, class 3 = 12.6%). In TAU, chronic trajectories were associated with being female, having a partner, and higher baseline depressive symptoms. In TDG-CBT, chronic trajectories were associated with not having a partner, lower income, higher depressive and panic symptoms, and antidepressant use. CONCLUSIONS: TDG-CBT nearly doubles the likelihood of recovery and reduces chronic symptom trajectories compared with TAU. Baseline clinical severity and socioeconomic vulnerability may help identify patients at risk of chronic symptom courses and guide more tailored treatment strategies.
PY - 2026
SN - 0022-3999
SP - 112652
ST - Trajectories of persistent physical symptoms in primary care: A secondary analysis of the PsicAP randomized clinical trial comparing CBT versus treatment as usual
T1 - Trajectories of persistent physical symptoms in primary care: A secondary analysis of the PsicAP randomized clinical trial comparing CBT versus treatment as usual
T2 - J Psychosom Res
TI - Trajectories of persistent physical symptoms in primary care: A secondary analysis of the PsicAP randomized clinical trial comparing CBT versus treatment as usual
U1 - Medically Unexplained Symptoms
U3 - 10.1016/j.jpsychores.2026.112652
VL - 207
VO - 0022-3999
Y1 - 2026
ER -