Sadlonova Monika, Löser Julia Katharina, Celano Christopher M, Kleiber Christina, Broschmann Daniel, Herrmann-Lingen Christoph
Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany.
Department of Cardiovascular and Thoracic Surgery, University of Göttingen Medical Center, Göttingen, Germany.
Front Psychiatry. 2022 Aug 25;13:964879. doi: 10.3389/fpsyt.2022.964879. eCollection 2022.
In Germany, multimodal psychosomatic inpatient treatment can be initiated for patients with substantial mental disorders (e.g., depression, anxiety, somatoform disorders) and comorbid physical disease. However, studies investigating changes in psychological and functional treatment outcomes, and predictors of long-term treatment effects in patients undergoing psychosomatic inpatient treatment are needed.
This cohort study analyzed 160 patients aged ≥18 who were treated on an integrated psychosomatic inpatient unit at the University of Göttingen Medical Center. Its aim was to analyze changes in psychological and functional outcomes, and to identify predictors of long-term improvements in health-related quality of life (HRQoL) in patients with comorbid mental and physical illness who were undergoing integrated inpatient psychosomatic treatment. Assessments were completed at admission, discharge, and 12- or 24-month follow-up. Outcomes included physical complaints [Giessen Subjective Complaints List (GBB-24)], psychological symptoms [Brief Symptom Inventory (BSI)], and HRQoL [European Quality of Life Questionnaire (EQ-5D)].
One-hundred sixty inpatients were included (mean age = 53.1 ± 12.6; 53.8% female). There were significant, medium- to large-sized improvements in psychological symptoms (BSI-Global Severity Index; = -0.83, < 0.001), physical symptom burden ( = -0.94, < 0.001), and HRQoL ( = 0.65, < 0.001) from admission to discharge, and significant, small- to medium-sized greater improvements in all psychological outcomes from admission to follow-up (BSI-GSI: = -0.54, p < 0.001; GBB-24 total symptom burden: = -0.39, < 0.001; EQ-5D: = 0.52, < 0.001). Furthermore, better improvement in HRQoL during hospitalization (partial η = 0.386; < 0.001) was associated with higher HRQoL at follow-up. Finally, intake of antidepressant at discharge was associated with impaired HRQoL at follow-up (η = 0.053; = 0.03).
There were significant short- and long-term improvements in psychological symptoms, physical complaints, and HRQoL after treatment on an integrated psychosomatic inpatient unit in patients with mental disorders and a comorbid physical disease.
在德国，对于患有严重精神障碍（如抑郁症、焦虑症、躯体形式障碍）及合并躯体疾病的患者，可启动多模式身心住院治疗。然而，需要开展研究来调查身心住院治疗患者的心理和功能治疗结果的变化，以及长期治疗效果的预测因素。
这项队列研究分析了160名年龄≥18岁、在哥廷根大学医学中心综合身心住院部接受治疗的患者。其目的是分析心理和功能结果的变化，并确定合并精神和躯体疾病且正在接受综合住院身心治疗的患者健康相关生活质量（HRQoL）长期改善的预测因素。在入院、出院以及12个月或24个月随访时完成评估。结果包括躯体主诉[吉森主观症状清单（GBB - 24）]、心理症状[简明症状量表（BSI）]和HRQoL[欧洲生活质量问卷（EQ - 5D）]。
纳入了160名住院患者（平均年龄 = 53.1 ± 12.6；53.8%为女性）。从入院到出院，心理症状（BSI - 总体严重程度指数；效应量 = -0.83，p < 0.001）、躯体症状负担（效应量 = -0.94，p < 0.001）和HRQoL（效应量 = 0.65，p < 0.001）有显著的中到大幅改善，从入院到随访，所有心理结果有显著的小到中度更大改善（BSI - GSI：效应量 = -0.54，p < 0.001；GBB - 24总症状负担：效应量 = -0.39，p < 0.001；EQ - 5D：效应量 = 0.52，p < 0.001）。此外，住院期间HRQoL的更好改善（偏η² = 0.386；p < 0.001）与随访时更高的HRQoL相关。最后，出院时服用抗抑郁药与随访时HRQoL受损相关（η² = 0.053；p = 0.03）。
对于患有精神障碍及合并躯体疾病的患者，在综合身心住院部接受治疗后，心理症状、躯体主诉和HRQoL在短期和长期均有显著改善。
