Trudie Chalder





A Transdiagnostic Approach to Persistent Physical Symptoms Focusing on Fatigue

Scientific background and description of workshop:

Medically Unexplained Symptoms (MUS) are defined as persistent bodily symptoms with functional disability but no explanatory pathology.  Other terms include Somatic Symptom Disorder (SDD) which is used in the new Diagnostic Statistics Manual (DSM-5). This refers to persistent (6 months or more) and clinically significant somatic complaints accompanied by excessive and disproportionate health-related thoughts, feelings and behaviours regarding the symptoms. The somatic symptoms can be related to long term conditions as well as in the context of medically unexplained syndromes.

A healthy population (Marks & Hunter 2014) and group of chronic fatigue syndrome patients (Picariello et al., 2015) prefer the term persistent physical symptoms (PPS).  The management of patients with persistent physical symptoms and long term conditions are a significant challenge to the NHS.  Psychiatric co-morbidity rates are high. Research suggests that affective, cognitive and behavioural responses perpetuate symptoms and disability. A transdiagnostic but formulation based treatment approach based on cognitive behavioural models can be used to improve people’s quality of life. This workshop will focus specifically on fatigue which is ubiquitous in long term conditions.

Key learning objectives:

1. To gain an understanding of the specific affective, cognitive, behavioural and social responses that may be perpetuating symptoms and disability
3. To gain an understanding of the most effective interventions for fatigue in a variety of contexts

Training modalities:

Didactic teaching
Role play

Key references:

Deary, V., Chalder, T., Sharpe, M. (2007).  The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review.  Clinical Psychology Review 27, 781–797.
Dimsdale, J., Creed, F., Escobar, J. et al. (2013).  Somatic Symptom Disorder:  An important change in DSM.  Journal of Psychosomatic Research, 75, 3, 223-228.
Chalder, T. & Willis, C. (in press).  ‘Lumping’ and ‘splitting’ medically unexplained symptoms:  Is there a role for a transdiagnostic approach?  Journal of Mental Health.

Brief description of workshop leader(s)
Trudie Chalder is Professor of Cognitive Behavioural Psychotherapy at King’s College London. She has worked as a clinician and a researcher in the area of long term conditions and medically unexplained symptoms for about 30 years. She has a specific interest in fatigue. She develops specific cognitive behavioural models for understanding and treating these conditions and evaluates the approaches within the context of randomised controlled trials in primary and secondary care. Her research involves investigating not only whether treatment works in the context of gold standard randomised controlled trials but how and for whom it works. Her work spans adolescents and adults.

Trudie has published approximately 250 articles. She was the President of the British Association of Behavioural and Cognitive Psychotherapy and is an Editor of the Journal of Mental Health.