Knefel Matthias, Toro Sylvia, Meier Maria, Wlassits Wilhelm, Pidlich Johann
Landesklinikum Baden-Mödling Waltersdorfer Straße 75 A-2500 Baden Österreich.
Fakultät für Psychologie Universität Wien Österreich.
Z Psychosom Med Psychother. 2021 Dec;67(4):381-402. doi: 10.13109/zptm.2021.67.oa7. Epub 2021 Apr 27.
Medical care for psychosomatic patients in Austria differs from Germany. Besides treatment in psychiatric wards, there are also inpatient programs for psychosomatic patients integrated in internal medical departments. Such an integrated ward in Lower Austria operates for more than 35 years and treats internal-psychosomatic and gastroenterological patients. However, its effectiveness was not yet evaluated. The aim of the current study was to evaluate the effectiveness of an inpatient program for psychosomatic patients. In total, 184 patients participated in the naturalistic study and filled in questionnaires at admission and discharge from inpatient treatment. Primary endpoint was the difference in global symptom burden, as well as symptom burden in the areas of somatization, anxiety, and depression as measured with the Brief Symptom Inventory (BSI) between admission and discharge. Secondary endpoints were body image (FKB-20) and subjective therapeutic success (BVB-2000). The predictive power of the Structure of Personality (OPD-SF) and adverse childhood experiences (ACE-D) was also investigated. A smaller sample of 59 patients also participated in a four-month follow up assessment. The inpatient treatment was associated with improvement in the primary endpoints that can be interpreted as large effects. The effects were also small to large for the secondary endpoints, however, the improvement was smaller at the follow up time point. Patients with deficits in the dimensions regulation of relationships and internal emotional communication showed less improvement. Symptoms improve over the course of the evaluated inpatient treatment program. Specific dimension of the structure of personality predict treatment response and should be considered in treatment planning. This study provides initial evidence for the presented internal-psychosomatic inpatient program. The program might act as model for psychosomatic medical care in Austrian hospitals.
奥地利针对心身疾病患者的医疗护理与德国不同。除了在精神科病房进行治疗外，在内科部门也设有针对心身疾病患者的住院项目。奥地利下奥地利州的这样一个综合病房已经运营了35年多，治疗内科-心身疾病和胃肠病患者。然而，其有效性尚未得到评估。本研究的目的是评估针对心身疾病患者的住院项目的有效性。共有184名患者参与了这项自然主义研究，并在住院治疗的入院和出院时填写了问卷。主要终点是使用简明症状量表（BSI）测量的入院和出院之间全球症状负担的差异，以及躯体化、焦虑和抑郁领域的症状负担。次要终点是身体意象（FKB-20）和主观治疗效果（BVB-2000）。还研究了人格结构（OPD-SF）和童年不良经历（ACE-D）的预测能力。59名患者的较小样本也参与了为期四个月的随访评估。住院治疗与主要终点的改善相关，可解释为有较大效果。次要终点的效果也为小到中等，但在随访时间点改善较小。在人际关系调节和内部情感沟通维度存在缺陷的患者改善较少。在评估的住院治疗项目过程中症状有所改善。人格结构的特定维度可预测治疗反应，在治疗计划中应予以考虑。本研究为所介绍的内科-心身疾病住院项目提供了初步证据。该项目可能成为奥地利医院心身疾病医疗护理的典范。
