Tritt Karin, Nickel Marius, Mitterlehner Ferdinand, Nickel Cerstin, Forthuber Petra, Leiberich Peter, Rother Wolfhardt, Loew Thomas
Section of Psychosomatic Medicine, University Clinic of the University Regensburg, Regensburg, Germany.
Wien Klin Wochenschr. 2004 Mar 31;116(5-6):182-9. doi: 10.1007/BF03040485.
The major goal of this study was to determine indictors of long-term disability for psychosomatic inpatients with chronic fatigue syndrome. To this end, a cross-sectional study was performed with a random sample of patients (n=1000, response rate: 83.9%) at a psychosomatic inpatient clinic. 51.1% of the patients (n=429) reported intensely persistent exhaustion that had no logical relation to actual exertion. 159 (37.1%) patients in this group were disabled from working and these comprised the main target group of this study. Significantly more patients in the target group worked part time, were disabled for a disproportionately long period of time (50.9% of all were disabled for more than 6 months in the previous year), and felt stressed because of conflicts with their superiors and/or colleagues (in each case, P<0.01). While more frequent psychological comorbidity was not found, they reported physical complaints more often. It was not the patients fit for work who felt more burdened with chronic fatigue, but rather the employment-disabled, who were actually exposed to fewer demands. These patients had, in comparison with those fit to work, a stronger fixation on somatic complaints, inadequate perception of physical and psychic sensations, difficulties getting along with other people and in coping with a regular job (in each case, P<0.01). Prospective examination of these indicators could help detect predictor variables for long-term disability in chronic fatigue. Such predictors could contribute to timely social-medical assessment and treatment.
本研究的主要目的是确定慢性疲劳综合征心身疾病住院患者长期残疾的指标。为此，在一家心身疾病住院诊所对患者进行了横断面研究，随机抽取了1000名患者（应答率：83.9%）。51.1%的患者（n = 429）报告有强烈的持续性疲劳，且与实际劳累无逻辑关系。该组中有159名（37.1%）患者无法工作，这些患者构成了本研究的主要目标群体。目标群体中从事兼职工作的患者明显更多，残疾时间长得不成比例（去年所有患者中有50.9%的人残疾超过6个月），并且因与上级和/或同事发生冲突而感到压力（每种情况，P<0.01）。虽然未发现更频繁的心理合并症，但他们更常报告身体不适。感到慢性疲劳负担更重的并非适合工作的患者，而是就业残疾患者，他们实际面临的要求更少。与适合工作的患者相比，这些患者对躯体不适的执着更强，对身体和心理感觉的感知不足，在与他人相处和应对日常工作方面存在困难（每种情况，P<0.01）。对这些指标进行前瞻性检查有助于发现慢性疲劳长期残疾的预测变量。此类预测因素有助于及时进行社会医学评估和治疗。
