A Randomized Clinical trial to Evaluate Reduction of DASS-21 Stress Score in Psychosomatic Disorders using Mind-Ailments from as an Eliminative Rubric

Abstract

Background: Psychosomatic disorders arise when persistent psychological stress adversely affects bodily functions, primarily mediated by the hypothalamic-pituitary-adrenal (HPA) axis. In the homoeopathic medical science, the cause of the illness plays a key role in selecting a remedy, uniquely considering how the mind plays a role in health and illness. This study aims to evaluate the reduction of DASS-21 'Stress' scores by comparing 3rd-grade versus 1st-grade remedies, utilizing the ‘Mind Ailments from’ as an eliminative rubric in cases of psychosomatic disorders using Synthesis repertory.
Material and Methods: A prospective, randomized, single-blind clinical study was conducted at Bharati Vidyapeeth Homoeopathic Medical College and Hospital. The study included 52 patients (aged 18-60) with psychosomatic diseases and baseline DASS-21 stress scores > 15. Participants were equally divided into Group A (3rd-grade remedies, n=26) and Group B (1st-grade remedies, n=26). Outcomes were measured using DASS-21 and Psychosomatic Symptoms Questionnaire (PSQ-39) scales before and after the intervention. The Mann-Whitney U test was used for between group comparisons and the Wilcoxon signed-rank test for within-group variation.
Result: Both treatment cohorts shows statistically significant within-group reductions in psychological and physiological distress (p < 0.01). Between-group comparisons established the statistical superiority of the first-grade remedy intervention. The first-grade cohort achieved a mean DASS-21 score reduction of 11.92 ± 1.44, compared to 7.31 ± 1.38 in the third-grade cohort. Similarly, the mean PSQ-39 score reduction was 36.04 ± 3.50 for the first-grade group versus 19.08 ± 2.38 for the third-grade group. First-grade interventions yielded marked (21.15%) and moderate (23.08%) clinical improvements, whereas third-grade interventions predominantly yielded mild (36.54%) improvements.
Conclusion: While both remedy grades provided statistically significant amelioration of symptoms, First-grade remedies selected using Synthesis Repertory with “Mind–Ailments from” as an eliminative rubric produced greater reductions in DASS-21stress score and PSQ-39 scores. Patients receiving first-grade remedies showed predominantly moderate-to-marked clinical improvement, whereas third-grade remedies showed mainly mild improvement. These findings underscore the critical importance of efficacy of remedy grading in clinical practice, advocating for the prioritization of first-grade indications to optimize patient outcomes and enhance the quality of life in individuals suffering from psychosomatic disorders.