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Broadening transdiagnostic perspectives on persistent physical symptoms: integrating psychodynamic therapies

Published online by Cambridge University Press:  16 April 2026

Daniel Maroti Open the ORCID record for Daniel Maroti [Opens in a new window]  and
Mattias Rööst
Daniel Maroti*
Affiliation:
A psychologist and researcher in the Department of Psychology, Faculty of Social Sciences, Stockholm University, Sweden. He studies long-term physical symptoms and how psychological factors – especially trauma and emotion-focused therapies – affect both mind and body. He also works clinically as a psychologist and leads research on psychodynamic and emotion-focused treatments (especially emotional awareness and expression therapy).
Mattias Rööst
Affiliation:
A physician and Associate Professor in Family Medicine and Community Medicine in the Department of Clinical Sciences, Faculty of Medicine, Lund University, Sweden. He is trained in intensive short-term psychodynamic therapy and specialises in general practice and primary care research, focusing on healthcare delivery. He also supervises research and contributes to medical education and publications in primary care.
*
Correspondence Daniel Maroti. Email: daniel.maroti@su.se
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Summary

The predominant transdiagnostic perspective on persistent physical symptoms (PPS), as described by Felton et al in this journal, is largely shaped by cognitive–behavioural models. This commentary advocates expanding this perspective to include greater focus on a psychodynamic model that addresses interpersonal and emotional processes associated with the development and maintenance of PPS.

Keywords

Persistent physical symptomsemotional awareness and expression therapyintensive short-term psychodynamic therapytransdiagnostic treatmenttransdiagnostic conceptualisation

Information

Type
Commentary
Information
BJPsych Advances , First View , pp. 1 - 3
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Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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Footnotes

†

Commentary on… Transdiagnostic approach to understanding persistent physical symptoms. See this issue.

References

Abbass, A, Lumley, MA, Town, J, et al (2021) Short-term psychodynamic psychotherapy for functional somatic disorders: a systematic review and meta-analysis of within-treatment effects. Journal of Psychosomatic Research, 145: 110473.CrossRefGoogle ScholarPubMed
Felton, L, Sira Mahalingappa, S, Husain, M, et al (2026) Transdiagnostic approach to understanding persistent physical symptoms. BJPsych Advances, 32: 100–10.CrossRefGoogle Scholar
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Maroti, D, Ljótsson, B, Lumley, MA, et al (2021) Emotional processing and its association to somatic symptom change in emotional awareness and expression therapy for somatic symptom disorder: a preliminary mediation investigation. Frontiers in Psychology, 12: 712518.CrossRefGoogle ScholarPubMed
Maroti, D, Lumley, MA, Schubiner, H, et al (2022) Internet-based emotional awareness and expression therapy for somatic symptom disorder: a randomized controlled trial. Journal of Psychosomatic Research, 163: 111106.CrossRefGoogle ScholarPubMed
Maroti, D, Frisch, S, Lumley, MA (2025) To feel is to heal: introduction to emotional awareness and expression therapy. Schmerz, 39: 256–62.10.1007/s00482-025-00878-6CrossRefGoogle ScholarPubMed
Yarns, BC, Lumley, MA, Cassidy, JT, et al (2020) Emotional awareness and expression therapy achieves greater pain reduction than cognitive behavioral therapy in older adults with chronic musculoskeletal pain: a preliminary randomized comparison trial. Pain Medicine, 21: 2811–22.CrossRefGoogle ScholarPubMed
Yarns, BC, Jackson, NJ, Alas, A, et al (2024) Emotional awareness and expression therapy vs cognitive behavioral therapy for chronic pain in older veterans: a randomized clinical trial. JAMA Network Open, 7: e2415842.CrossRefGoogle ScholarPubMed
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