van der Feltz-Cornelis Christina M, Elfeddali Iman, Werneke Ursula, Malt Ulrik F, Van den Bergh Omer, Schaefert Rainer, Kop Willem J, Lobo Antonio, Sharpe Michael, Söllner Wolfgang, Löwe Bernd
Clinical Centre of Excellence for Body, Mind, and Health, GGz Breburg, Tilburg, Netherlands.
Tranzo Department, Tilburg University, Tilburg, Netherlands.
Front Psychiatry. 2018 May 14;9:151. doi: 10.3389/fpsyt.2018.00151. eCollection 2018.
Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe.
躯体症状障碍(SSD)、身体不适障碍(BDD)和功能障碍(FD)会带来高昂的医疗和社会成本,对欧洲的民众和卫生政策构成重大挑战。为应对这一挑战,需要制定一项特定的研究议程,作为欧洲针对SSD、BDD和FD的可持续心理健康研究与卫生政策的基石之一。从欧洲视角确定与SSD、BDD和FD相关的主要挑战和研究重点。2016年7月至2017年10月进行了三轮德尔菲研究,包括3次研讨会和3次在线调查,涉及75名专家和21个欧洲国家。EURONET - SOMA和欧洲心身医学协会(EAPM)主办了这些会议。确定了八个研究重点:(1)评估与病程和治疗结果相关的诊断特征。(2)开发和评估新的有效干预措施。(3)在此背景下评估慢性疾病的问卷或半结构化访谈的验证研究。(4)研究患者对诊断和治疗的偏好。(5)开发新的方法设计,以识别和探索临床病程和治疗结果的调节因素和中介因素(6)。转化研究,探索心理和躯体症状如何从躯体状况以及生物和行为致病因素发展而来。(7)开发新的有效干预措施以实现个性化治疗。(8)在不同环境(如初级保健、职业保健、综合医院和专科心理健康机构)中进行治疗干预的实施研究。公众和政策制定者将受益于为SSD、BDD和FD开发的新的、有效的、个性化的干预措施,这些措施将通过转化研究得到加强,也将受益于患者参与、全科医生与患者沟通、咨询 - 联络模式及实施方面的研究成果。迫切需要为这一研究议程提供资金,在诸如EURONET - SOMA和EAPM等协调研究网络中应对这些挑战,并由政策制定者系统地将资源分配到身心健康这一关键领域,以提高全欧洲SSD、BDD和FD诊断与治疗的疗效和影响力。