Hoffmann Ditte, Rask Charlotte Ulrikka, Hedman-Lagerlöf Erik, Eilenberg Trine, Frostholm Lisbeth
Postdoctoral Researcher, The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark.
Professor, Child and Adolescent Psychiatric Centre, Risskov, Aarhus University Hospital, Denmark.
BJPsych Open. 2019 Sep 9;5(5):e80. doi: 10.1192/bjo.2019.54.
Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay.
This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment.
Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics.
In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P<0.001) and better physical health-related quality of life (P<0.001) suggesting a more distinct symptom profile.
Self-referral was found to be an accurate method to recruit highly relevant patients with treatment-demanding health anxiety. Thus, both self-referral and clinician-referral seem feasible and valid referral methods, but they may recruit patients with slightly different characteristics.
None.
严重健康焦虑症若不治疗，是一种慢性且代价高昂的疾病。患者自我转诊可能会降低治疗障碍并减少诊断延迟。
本研究评估了严重健康焦虑症自我转诊的准确性，并比较了自我转诊接受网络治疗的患者与临床医生转诊接受面对面治疗的患者的特征。
同一诊所的两项试验采用了不同的健康焦虑症转诊方法，即自我转诊和临床医生转诊（试验注册：clinicaltrials.gov：NCT01158430和NCT02735434）。试验在不同时间点进行，但资格标准基本可比。通过查看两项试验中符合条件的患者数量来比较招募方法的准确性。患者完成一份基线问卷，随后由经验丰富的临床医生进行诊断访谈。探讨自我报告与临床数据之间的平均差异，以了解组间人口统计学和临床特征。
总共，101/151（67%）的自我转诊患者符合条件，而临床医生转诊的患者为126/254（50%）（P = 0.001）。自我转诊患者年龄大3.4岁（P = 0.008），教育水平略高（P = 0.030）。与临床医生转诊的患者相比，自我转诊的患者报告的健康焦虑、情绪困扰和躯体症状水平显著更高。然而，他们经临床医生评估的共病焦虑症较少（P<0.001），与身体健康相关的生活质量更好（P<0.001），这表明症状特征更为明显。
自我转诊被发现是招募有严重健康焦虑症且急需治疗的高度相关患者的一种准确方法。因此，自我转诊和临床医生转诊似乎都是可行且有效的转诊方法，但它们可能招募到特征略有不同的患者。
无。
