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基层医疗中患者特征与身体不适综合征的发生率:一项横断面研究。

Patient characteristics and frequency of bodily distress syndrome in primary care: a cross-sectional study.

作者信息

Budtz-Lilly Anna, Vestergaard Mogens, Fink Per, Carlsen Anders Helles, Rosendal Marianne

机构信息

Research Unit for General Practice, Department of Public Health, Aarhus University, Denmark.

Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark.

出版信息

Br J Gen Pract. 2015 Sep;65(638):e617-23. doi: 10.3399/bjgp15X686545.

Abstract

BACKGROUND

Bodily distress syndrome (BDS) is a newly proposed diagnosis of medically unexplained symptoms, which is based on empirical research in primary care.

AIM

To estimate the frequency of BDS in primary care and describe the characteristics of patients with BDS.

DESIGN AND SETTING

A cross-sectional study of primary care patients in urban and rural areas of Central Denmark Region.

METHOD

Data were obtained from GP one-page registration forms, patient questionnaires (including a checklist for BDS), and national registers.

RESULTS

A total of 1356 primary care patients were included, of whom 230 patients (17.0%, 95% confidence intervals [CI] = 15.0 to 19.1) fulfilled the BDS criteria. BDS was more common among primary care patients aged 41-65 years (odds ratio [OR] = 1.9, 95% CI = 1.3 to 3.0) and was equally frequent among males and females (female sex, OR 0.9, 95% CI = 0.6 to 1.3). Patients with BDS were characterised by poor health-related quality of life (HRQOL) on the 12-item Short-Form Health Survey, that is, physical component summary scores <40 (OR 20.5, 95% CI = 12.9 to 32.4) and mental component summary scores <40 (OR 3.5, 95% CI = 2.2 to 5.6). Furthermore, patients with BDS were more likely to have high scores on the Symptom Checklist for anxiety (OR 2.2, 95% CI = 1.4 to 3.4) and depression (OR 5.1, 95% CI = 3.3 to 7.9), but regression analyses showed that mental morbidity did not account for the poor HRQOL.

CONCLUSION

BDS is common among primary care patients, and patients with BDS have a higher probability of poor HRQOL and mental health problems.

摘要

背景

身体不适综合征(BDS)是一种新提出的对医学上无法解释的症状的诊断,它基于初级保健中的实证研究。

目的

评估初级保健中BDS的发生率,并描述BDS患者的特征。

设计与地点

对丹麦中部地区城乡初级保健患者的一项横断面研究。

方法

数据来自全科医生的单页登记表、患者问卷(包括BDS检查表)和国家登记册。

结果

共纳入1356名初级保健患者,其中230名患者(17.0%,95%置信区间[CI]=15.0至19.1)符合BDS标准。BDS在41 - 65岁的初级保健患者中更常见(优势比[OR]=1.9,95%CI = 1.3至3.0),在男性和女性中发生率相同(女性,OR 0.9,95%CI = 0.6至1.3)。BDS患者在12项简短健康调查问卷中的健康相关生活质量(HRQOL)较差,即身体成分总结得分<40(OR 20.5,95%CI = 12.9至32.4)和精神成分总结得分<40(OR 3.5,95%CI = 2.2至5.6)。此外,BDS患者在焦虑症状检查表(OR 2.2,95%CI = 1.4至3.4)和抑郁症状检查表(OR 5.1,95%CI = 3.3至7.9)上得分更高,但回归分析表明精神疾病并非导致HRQOL差的原因。

结论

BDS在初级保健患者中很常见,且BDS患者的HRQOL较差和存在心理健康问题的可能性更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5427/4540402/7aeb7b7ba831/bjgpsep-2015-65-638-e617-oaf1.jpg

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