Results (
Thai) 2:
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Publication bias
Limitation
The results of this meta-analysis should be interpreted within the context of its methodological limitations. First, the small number of the studies limited the ability to draw definite conclusions. Second, heterogeneity of the studies and outcome measures may have influenced result, although we used conservative confidence intervals for the estimation of effect sizes. Third, publication bias was present, although did not appear to have significantly influenced the result. Fourth, study quality was moderately poor on average. Fifth, most outcome assessment relied only on patients’ self-reports. Sixth, the use of concomitant medications was not reported in each study. Seventh, a meta-analysis of between-group contrasts was not feasible, because three of the retrieved effectiveness studies were non-inferiority trails comparing two forms of CBT and seven studies had no control treatment, thus hampering between group comparisons. Eighth, as all studies involved patient with severe somatoform disorder, results form the meta-analysis do not generalize to syndromes labeled ‘functional somatic syndrome’, ‘medically unexplained physical symptoms’ or ‘abridged somatisation disorder’, and chronic diseases with multiple physical symptoms. Finally, in light of recent changes in diagnostic classification, it remains uncertain how the findings in this group of somatoform disorders will translate to the revised diagnostic system in DSM-5
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