Division of Clinical Psychology and Psychological Therapy, Department of Psychology, Philipps University of Marburg, D-35032 Marburg, Germany.
J Psychosom Res. 2010 Mar;68(3):253-62. doi: 10.1016/j.jpsychores.2009.09.012. Epub 2009 Dec 9.
Previous research suggests that medically unexplained symptoms (MUS) are maintained in an interpersonal context. The current study examined MUS concurrently and prospectively by measuring specific interpersonal predictors of symptom severity and health care use.
A total of 127 patients with MUS and their significant others were recruited through primary care offices and assessed with self-report questionnaires and structured interviews about illness attributions, illness behavior and responses, relationship quality, symptom severity, and health care use at baseline and 6-month follow-up.
Illness attributions and interpersonal illness behaviors of patients with MUS were cross-sectionally associated with illness attributions and responses of the patients' significant others. Relationship quality was related to specific illness behaviors and responses. Symptom severity at baseline was predicted by patients' somatic illness attributions. Symptom severity at 6-month follow-up was predicted by somatic illness attributions of patients and withdrawal of patients' significant others at baseline, but these predictors became insignificant when correcting for baseline symptomatology. Health care use at baseline was predicted by a greater amount of coping behavior and higher anxiety scores of patients, and health care use at 6-month follow-up was predicted by more attention-seeking behaviors and health care use of patients at baseline.
The results document the interpersonal influences on the maintenance of MUS. The perspective of significant others should be considered for enhancement of psychological approaches to the treatment of patients with MUS.
先前的研究表明，医学无法解释的症状（MUS）是在人际环境中维持的。本研究通过测量症状严重程度和医疗保健使用的特定人际预测因子，同时和前瞻性地检查了 MUS。
通过初级保健办公室招募了 127 名患有 MUS 的患者及其重要他人，并使用自我报告问卷和结构化访谈，在基线和 6 个月随访时评估疾病归因、疾病行为和反应、关系质量、症状严重程度和医疗保健使用情况。
MUS 患者的疾病归因和人际疾病行为与患者重要他人的疾病归因和反应呈横断面相关。关系质量与特定的疾病行为和反应有关。基线时的症状严重程度由患者的躯体疾病归因预测。6 个月随访时的症状严重程度由患者的躯体疾病归因和患者重要他人的基线退缩预测，但在对基线症状进行校正后，这些预测因素变得不显著。基线时的医疗保健使用由患者更多的应对行为和更高的焦虑评分预测，而 6 个月随访时的医疗保健使用则由患者更多的寻求关注行为和基线时的医疗保健使用预测。
这些结果记录了人际因素对 MUS 维持的影响。在治疗 MUS 患者时，应考虑重要他人的观点，以增强心理方法。
