• Nyoman Triska Ariyanti Internship Doctor Program (medical doctor) Rumah Sakit Bangli Medika Canti, Bali, Indonesia



Psychotherapy, Cognitive Behavioral Therapy


Introduction – Somatic symptom disorder (SSD), before known as somatoform disorder (SD), is characterized by a preoccupation that is nondelusional and general with fears of having, or the idea that the body has a serious disease based on his or her misinterpretation of bodily symptoms in six or more months. In SSD management there is a multifaceted approach that is tailored to each patient. Psychological interventions specifically cognitive behavioral therapy reported can improve the symptoms and reduce the healthcare cost significantly. Internet-delivered cognitive behavior therapy (ICBT) has an accepted evidence base for a range of psychiatric problems, especially for SSD treatment also has been suggested as one possible approach that could adapted to this situation.

Methods – In this article, researchers used the review method by collecting several kinds of literature from 2011-2021 that discuss somatic symptom disorder, cognitive behavioral therapy, and internet-based cognitive behavioral therapy for somatic symptom disorder.

Results – A referral system for patients with SSD to a mental health expert is needed if they do not find any progress when handled by the physician in primary care. Proven therapies for SSD such as CBT and mindfulness-based therapy. ICBT was approved and increased usage within the pandemic of COVID-19 and brought some highly standardized courses consistent across patients.

Discuss – The effectiveness of ICBT has been evaluated in the management of generalized anxiety disorder (GAD), depression, panic disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), adjustment disorder, chronic pain, bipolar disorder, and phobias. CBT in multicenter randomized controlled trials reported effectiveness in the treatment of SSD and medically unexplained symptoms, “Health anxious” patients get over two years of sustained symptomatic benefit, without any different impact on total costs, and also decreased the physical symptoms, disability, and psychological distress.

Conclusion – Internet-based Cognitive Behavioral Therapy (ICBT) can be highly effective in the treatment of somatic symptom disorder (SSD). ICBT can provided in therapist-guided, unguided, or as a bibliotherapy. This tool is already recommended as a treatment of choice during the pandemic. Although wider RCT on the use of ICBT in clinical practice, particularly in SSD therapy, with a variety of demographic characteristics to provide additional evidence of the effectiveness of this technique, as well as increased awareness among clinicians and the general public.

Keywords: SSD, somatic, CBT.


Sadock B, Sadock V, Ruiz P. Synopsis of psychiatry. 11th ed. Philadelphia, Pa: Wolters Kluwer; 2015.

Sherry DD, Gmuca S. Somatic Symptom Disorder and the Physician’s Role. JAMA Pediatrics. 2020 Oct 1;174(10):1001. Https://

Witthöft M, Jasper F. Somatic Symptom Disorder. InEncyclopedia of Mental Health: Second Edition 2016 Jan 1 (pp. 211-214). Elsevier Inc..

American Psychiatric Association. The diagnostic and statistical manual (5th ed.). Washington: Author. (2013).

Heinbokel C, Lehmann M, Pohontsch NJ, Zimmermann T, Althaus A, Scherer M, Löwe B. Diagnostic barriers for somatic symptom disorders in primary care: study protocol for a mixed methods study in Germany. BMJ open. 2017 Aug 1;7(8):e014157. Https://

Kurlansik SL, Maffei MS. Somatic symptom disorder. American family physician. 2016 Jan 1;93(1):49-54.

Holmberg N, Kähkönen S. Internet-based cognitive-behavioral therapy in the treatment of psychiatric disorders. Duodecim; laaketieteellinen aikakauskirja. 2011 Jan 1;127(7):692-8.

Aminoff V, Sellén M, Sörliden E, Ludvigsson M, Berg M, Andersson G. Internet-Based Cognitive Behavioral Therapy for Psychological Distress Associated With the COVID-19 Pandemic: A Pilot Randomized Controlled Trial. Frontiers in Psychology. 2021 Jun 14;12:1998.


De Nardi L, Abbracciavento G, Cozzi G, Ronfani L, Viola I, Bigolin L, Barbi E, Trombetta A. Adolescents with somatic symptom disorder experienced less anxiety and depression than healthy peers during the first COVID‐19 lockdown. Acta paediatrica. 2021 Apr 16.

Van Driel TJ, Hilderink PH, Hanssen DJ, De Boer P, Rosmalen JG, Oude Voshaar RC. Assessment of somatization and medically unexplained symptoms in later life. Assessment. 2018 Apr;25(3):374-93.

Ikatan Dokter Indonesia. Panduan praktik klinis bagi dokter di fasilitas pelayanan kesehatan primer. Jakarta: Kementrian Kesehatan RI. 2014.

Tamás RB, Perczel-Forintos D, Máté O, Gyenge Z. Szomatizációs zavarok kezelése gyermekkorban: bizonyítottan hatékony pszichoterápiás módszerek. Orvosi Hetilap. 2020 Jun;161(25):1050-8.

Verdurmen MJ, Videler AC, Kamperman AM, Khasho D, van der Feltz-Cornelis CM. Cognitive behavioral therapy for somatic symptom disorders in later life: a prospective comparative explorative pilot study in two clinical populations. Neuropsychiatric disease and treatment.2017;13:2331.

Newby J, Mason E, Kladnistki N, Murphy M, Millard M, Haskelberg H, Allen A, Mahoney A. Integrating internet CBT into clinical practice: a practical guide for clinicians. Clinical Psychologist. 2021 Mar 17:1-5.

Kumar V, Sattar Y, Bseiso A, Khan S, Rutkofsky IH. The effectiveness of internet-based cognitive behavioral therapy in treatment of psychiatric disorders. Cureus. 2017 Aug;9(8).

Hedman E, Axelsson E, Andersson E, Lekander M, Ljotsson B. Exposure-based cognitive–behavioural therapy via the internet and as bibliotherapy for somatic symptom disorder and illness anxiety disorder: randomised controlled trial. The British journal of psychiatry. 2016 Nov;209(5):407-13.

Newby JM, Smith J, Uppal S, Mason E, Mahoney AE, Andrews G. Internet-based cognitive behavioral therapy versus psychoeducation control for illness anxiety disorder and somatic symptom disorder: A randomized controlled trial. Journal of Consulting and Clinical Psychology. 2018 Jan;86(1):89.

Hedman E, Axelsson E, Gorling A, Ritzman C, Ronnheden M, El Alaoui S, et al. Internet-delivered exposure-based cognitive–behavioural therapy and behavioural stress management for severe health anxiety: randomised controlled trial. Br J Psychiatry 2014; 205: 307–14.

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., et al. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health 17, 1729–1754. doi: 10.3390/ijerph17051729




How to Cite

Ariyanti, N. T. (2024). INTERNET-BASED COGNITIVE BEHAVIORAL THERAPY FOR SOMATIC SYMPTOM DISORDER. Journal of Psychiatry Psychology and Behavioral Research, 5(1), 39–43.