BACKGROUND Improving Access to Psychological Therapies is a UK Government funded initiative to widen access to psychological treatment for a range of common mental health complaints, such as depression and anxiety. More recently, the service has begun to treat patients with medically unexplained symptoms. This paper reports on a review of treatment protocols and early treatment data for medically unexplained symptoms, specifically the illness myalgic encephalomyelitis/chronic fatigue syndrome. MAIN TEXT A series of seven core problems and failings are identified, including an unproven treatment rationale, a weak and contested evidence-base, biases in treatment promotion, exaggeration of recovery claims, under-reporting of drop-out rates, and a significant risk of misdiagnosis and inappropriate treatment. CONCLUSIONS There is a pressing need for independent oversight of this service, specifically evaluation of service performance and methods used to collect and report treatment outcomes. This service offers uniform psycho-behavioural therapy that may not meet the needs of many patients with medically unexplained health complaints. Psychotherapy should not become a default when patients' physical symptoms remain unexplained, and patients should be fully informed of the rationale behind psychotherapy, before agreeing to take part. Patients who reject psychotherapy or do not meet selection criteria should be offered appropriate medical and psychological support.

中文翻译：

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通过改善心理治疗（IAPT）的机会来治疗医学上无法解释的症状：已确定主要局限性。

背景 改善心理治疗的可及性是英国政府资助的一项举措，旨在扩大针对一系列常见心理健康问题（如抑郁和焦虑）的心理治疗的可及性。最近，该服务已开始治疗患有医学上无法解释的症状的患者。本文报告了对医学上无法解释的症状，特别是肌痛性脑脊髓炎/慢性疲劳综合症的治疗方案和早期治疗数据的回顾。主要文本确定了一系列七个核心问题和缺陷，包括未经证实的治疗原理、薄弱且有争议的证据基础、治疗推广中的偏见、夸大康复声明、漏报退出率以及重大风险误诊和不适当的治疗。结论 迫切需要对该服务进行独立监督，特别是对服务绩效以及用于收集和报告治疗结果的方法进行评估。这项服务提供统一的心理行为治疗，但可能无法满足许多患有医学上无法解释的健康问题的患者的需求。当患者的身体症状仍无法解释时，心理治疗不应成为默认治疗，并且在同意参加之前应充分告知患者心理治疗背后的基本原理。应为拒绝心理治疗或不符合选择标准的患者提供适当的医疗和心理支持。