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基层医疗中的医学无法解释的躯体症状:家庭医生进行认知行为治疗的对照研究。

Medically unexplained physical symptoms in primary care: a controlled study on the effectiveness of cognitive-behavioral treatment by the family physician.

机构信息

Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.

出版信息

Psychosomatics. 2009 Sep-Oct;50(5):515-24. doi: 10.1176/appi.psy.50.5.515.

Abstract

BACKGROUND

Disabling medically unexplained physical symptoms occur in 16% of all patients in primary care.

OBJECTIVE

The aim of this study was to assess the effectiveness of a cognitive-behavioral intervention by the family physician.

METHOD

In a controlled design with detailed information on patient selection, 6,409 patients were screened on somatoform disorder, and 65 participants were allocated to care-as-usual or the experimental condition.

RESULTS

After 6 and 12 months, the cognitive-behavioral intervention by trained family physicians was not more effective than care-as-usual.

CONCLUSION

Possibly, the intensity of treatment was insufficient for the severe and persistent symptoms that were encountered in primary care.

摘要

背景

在初级保健中,16%的患者会出现医学无法解释的身体症状。

目的

本研究旨在评估家庭医生的认知行为干预的效果。

方法

采用详细的患者选择信息的对照设计,对 6409 名患者进行躯体形式障碍筛查,将 65 名参与者分配至常规护理组或实验组。

结果

经过 6 个月和 12 个月,经过培训的家庭医生实施的认知行为干预并不比常规护理更有效。

结论

可能是初级保健中遇到的严重和持续的症状,治疗强度不足。

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