Intergrin Academy, Geleen, Netherlands.
Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Psychother Res. 2023 Jun;33(5):581-594. doi: 10.1080/10503307.2022.2144528. Epub 2022 Dec 16.
Although multimodal interventions are generally recommended in patients with long-term somatic symptom disorders (SSD), available evidence is limited. The current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program for patients with SSD and predominant (spinal) pain.
The healthcare program consisted of two active treatment phases: main 20-week program and a 12-month relapse prevention program. Participants were 4453 patients diagnosed with SSD. The primary outcome was health-related quality of life (HRQoL) assessed using the RAND-36 (i.e., mental/physical component summary) and secondary outcomes included physical and psychological symptoms assessed using the Brief Symptom Inventory (BSI) and RAND-36 subscales. Mixed linear models were used to examine the effects of the multimodal healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of relapse prevention program (T3).
Significant improvements were found from T0 to T2 for all primary variables (i.e., mental/physical component summary) and secondary variables (i.e., BSI/RAND-36 subscales), which were maintained until the end of the relapse prevention program (T3).
An interdisciplinary multimodal integrative treatment for SSD is effective for improving HRQoL and reducing physical and psychological symptoms.
尽管一般建议对长期躯体症状障碍(SSD)患者采用多模式干预,但现有证据有限。本研究评估了针对 SSD 和主要(脊柱)疼痛患者的门诊二级护理多学科综合医疗计划的有效性。
该医疗计划包括两个主动治疗阶段:主要的 20 周计划和为期 12 个月的复发预防计划。参与者为 4453 名被诊断为 SSD 的患者。主要结局是使用 RAND-36(即心理/生理成分综合评分)评估的健康相关生活质量(HRQoL),次要结局包括使用 BSI(Brief Symptom Inventory)和 RAND-36 子量表评估的身体和心理症状。混合线性模型用于在四个时间点(开始 20 周计划前(T0)、20 周计划中途(T1)、20 周计划结束时(T2)和复发预防计划结束时(T3))上检查多模式医疗计划对主要/次要结局的影响。
所有主要变量(即心理/生理成分综合评分)和次要变量(即 BSI/RAND-36 子量表)均从 T0 到 T2 显示出显著改善,并且在复发预防计划结束时(T3)仍然保持。
针对 SSD 的跨学科多模式综合治疗对于提高 HRQoL 和减轻身体和心理症状是有效的。