Schweickhardt Axel, Larisch Astrid, Wirsching Michael, Fritzsche Kurt
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Freiburg, Freiburg, Germany.
Psychother Psychosom. 2007;76(6):339-46. doi: 10.1159/000107561.
Treatment acceptance and motivation for psychotherapy of somatizing patients in the general hospital is low.
Patients (n = 91) fulfilling the criteria for somatization were randomized into an intervention group (n = 49) and a control group (n = 42). The patients in the intervention group attended 5 psychotherapeutic sessions based on the modified reattribution model. The patients in the control group received psychoeducational reading material. The primary outcomes were motivation for psychotherapy and contacting a psychotherapist after discharge. The secondary outcomes consisted of changes regarding somatoform symptoms, emotional distress and quality of life.
Patients from the intervention group were significantly more motivated for psychotherapy (p = 0.001) than patients from the control group. At the 3-month follow-up, 42% of the patients from the intervention group had contacted a psychotherapist, compared to 20% of the patients from the control group (p = 0.045). At the 6-month follow-up, however, the ratio of patients having contacted a psychotherapist had changed to 44 and 29%, respectively, and was no longer significant. The intensity of somatoform symptoms and the anxiety symptoms decreased and mental functioning improved significantly over time for patients from both groups.
Short-term psychotherapeutic interventions for somatizing patients in general hospitals have a moderately better effect on motivation for psychotherapy and contacting a psychotherapist than psychoeducational reading material alone. Future studies should attempt to prove the effectiveness of short-term psychoeducational interventions for somatizing patients in the general hospital.
综合医院中躯体化患者对心理治疗的接受度和治疗动机较低。
符合躯体化标准的患者(n = 91)被随机分为干预组(n = 49)和对照组(n = 42)。干预组患者参加了基于改良归因模型的5次心理治疗课程。对照组患者收到了心理教育阅读材料。主要结局是心理治疗的动机和出院后联系心理治疗师的情况。次要结局包括躯体形式症状、情绪困扰和生活质量的变化。
干预组患者比对照组患者对心理治疗的动机明显更强(p = 0.001)。在3个月的随访中,干预组42%的患者联系了心理治疗师,而对照组为20%(p = 0.045)。然而,在6个月的随访中,联系心理治疗师的患者比例分别变为44%和29%,不再具有显著性差异。随着时间的推移,两组患者的躯体形式症状强度和焦虑症状均有所减轻,心理功能显著改善。
综合医院中对躯体化患者进行的短期心理治疗干预,在心理治疗动机和联系心理治疗师方面比单纯的心理教育阅读材料有适度更好的效果。未来的研究应尝试证明综合医院中对躯体化患者进行短期心理教育干预的有效性。