全科医生对躯体化患者的心理社会干预：一项随机对照试验。
Psychosocial interventions for somatizing patients by the general practitioner: a randomized controlled trial.
作者信息
Larisch Astrid, Schweickhardt Axel, Wirsching Michael, Fritzsche Kurt
机构信息
Department of Psychosomatics and Psychotherapy, University Hospital of Freiburg, Hauptstr. 8, Freiburg D-79104, Germany.
出版信息
J Psychosom Res. 2004 Dec;57(6):507-14; discussion 515-6. doi: 10.1016/j.jpsychores.2004.04.372.
OBJECTIVE
The objective of this study was to compare the effects of psychosocial interventions based on the modified reattribution model for somatizing patients in general practice (GP) with those of nonspecific psychosocial primary care (PPC) alone.
METHODS
Forty-two GPs were randomized, 23 into the intervention group (IG), who were trained in reattribution techniques, and 19 into the control group (CG). One hundred twenty-seven patients were included. Primary outcome measures were somatoform symptoms and quality of life.
RESULTS
Multilevel modeling revealed a reduction of physical symptoms (P = .007), an improvement in physical functioning (P = .0172), and a reduction of depression (P = .0211) and anxiety (P = .0388) in the IG compared with the CG at the 3-month follow-up. However, results no longer remained significant after controlling for baseline and covariate variables besides a reduction of physical symptoms at 6-month follow-up (P = .029).
CONCLUSION
Compared with nonspecific PPC, the effects of reattribution techniques were small and limited to physical symptoms.
目的
本研究的目的是比较基于改良归因模型的心理社会干预对全科医疗（GP）中躯体化患者的效果与单纯非特异性心理社会初级保健（PPC）的效果。
方法
42名全科医生被随机分组，23名进入干预组（IG），接受归因技术培训，19名进入对照组（CG）。纳入127名患者。主要结局指标为躯体形式症状和生活质量。
结果
多水平模型显示，在3个月随访时，与对照组相比，干预组的躯体症状减轻（P = 0.007），身体功能改善（P = 0.0172），抑郁（P = 0.0211）和焦虑（P = 0.0388）减轻。然而，在控制基线和协变量变量后，除了6个月随访时躯体症状减轻（P = 0.029）外，结果不再显著。
结论
与非特异性PPC相比，归因技术的效果较小，且仅限于躯体症状。
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