American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for medically unexplained symptoms (MUS)?

1. Medication management

2. Cognitive behavioral therapy (CBT)

3. Physical rehabilitation

4. Psychoanalysis

The correct answer is: Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) is considered the recommended treatment for medically unexplained symptoms (MUS) because it addresses the psychological and behavioral components associated with these symptoms. MUS often involve a complex interplay of psychological, physical, and social factors, and CBT can help patients understand and manage the thoughts and behaviors that contribute to their experiences of these symptoms. By focusing on cognitive restructuring and coping strategies, CBT can reduce symptom severity and improve overall functioning. Using CBT, patients learn to identify negative thought patterns related to their symptoms and develop healthier responses to stress and distress, which can lead to better management of their conditions. This therapeutic approach is evidence-based, showing effectiveness in helping individuals with a range of psychosomatic presentations, thus making it a preferred treatment option. Other treatments, such as medication management, physical rehabilitation, and psychoanalysis, may not specifically target the cognitive and emotional patterns associated with MUS in the same way CBT does, which is why they are typically not the first choice for these conditions. While medications can sometimes address associated symptoms like anxiety or depression, they do not directly address the core issues related to MUS as effectively as CBT.