Department of Clinical Psychology, Johannes Gutenberg-University of Mainz, 55122 Mainz, Germany.
Gen Hosp Psychiatry. 2011 Jul-Aug;33(4):318-26. doi: 10.1016/j.genhosppsych.2011.05.002. Epub 2011 Jun 11.
THEORY/OBJECTIVE: Somatoform disorder (SFD) is associated with considerable psychosocial impairment. However, only a few studies have dealt with the course of this clinical subgroup. Therefore, the objective was to identify predictors for the various courses of SFD and medically unexplained symptoms (MUS).
We screened 620 consecutive patients in primary care using the Patient Health Questionnaire (PHQ-15). Afterwards, 308 patients were studied in more detail using a diagnostic interview and a set of questionnaires. One year later, we were able to interview 277 participants a second time.
After 1 year, 48.8% of the respondents had a remitted SFD. The following variables proved to be significant predictors of MUS: current depressive episode, negative life events, number of MUS at baseline, attributional style, autonomic sensations and catastrophizing cognitions. The course of SFD could be predicted through current depressive or anxiety disorder, negative life events, functional disability and attributional style.
Somatoform disorder has a favorable course. The predictors of the courses of SFD and MUS we found can be integrated into previous explanatory models. The coping with MUS or SFD can be seen as a mediating factor.
理论/目的：躯体形式障碍（SFD）与相当大的心理社会功能损害有关。然而，只有少数研究涉及这一临床亚组的病程。因此，本研究的目的是确定躯体形式障碍和无法用医学解释的症状（MUS）各种病程的预测因素。
我们使用患者健康问卷（PHQ-15）对 620 名连续的初级保健患者进行了筛查。之后，使用诊断访谈和一系列问卷对 308 名患者进行了更详细的研究。一年后，我们能够对 277 名参与者进行第二次访谈。
一年后，48.8%的受访者的躯体形式障碍缓解。以下变量被证明是 MUS 的显著预测因素：当前抑郁发作、负性生活事件、基线时的 MUS 数量、归因方式、自主感觉和灾难化认知。SFD 的病程可以通过当前的抑郁或焦虑障碍、负性生活事件、功能障碍和归因方式来预测。
躯体形式障碍的病程良好。我们发现的 SFD 和 MUS 病程的预测因素可以整合到以前的解释模型中。应对 MUS 或 SFD 可以被视为一个中介因素。
