Yang Xiangyun, Luo Jia, Wang Pengchong, He Yue, Wang Cong, Yang Lijuan, Sun Jing, Li Zhanjiang
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Hutong Deshengmen Wai, Xicheng District, Beijing, 100088, China.
Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
Ann Gen Psychiatry. 2023 Aug 12;22(1):30. doi: 10.1186/s12991-023-00457-y.
In China, patients with somatoform disorders (SFD) often seek medical treatment repeatedly in outpatient clinics of general hospitals, which increases unreasonable medical expenses. It is imperative to provide early screening to these patients and specialized treatment to reduce the unnecessary cost. This study aimed to screen patients with SFD in general hospitals using a new Chinese questionnaire and explore the characteristics and economic burden of these patients.
Patients (n = 1497) from the outpatient department of neurology, cardiology and gastroenterology of three large general hospitals were included. Participants were screened using a newly developed questionnaire, the Self-screening Questionnaire for Somatic Symptoms (SQSS), to identify the patients with SFD (total SQSS score ≥ 29 points). We compared the demographics and clinical information of patients with and without SFD. Logistic regression was used to explore potential factors related to medical expenses, visits to doctors and sick leave days taken.
The frequency of detection of patients with SFD was 17.03%. There were significant differences in employment, doctor visits, symptom duration, medical expenses, sick leave days, PHQ-15 scores, and PHQ-9 scores between patients with SFD and without SFD. General nonspecific somatic symptoms were frequently present in patients with SFD. Several potential factors were associated with higher medical expenses, repeated doctor visits, and sick leave days taken in the regression analysis.
The findings indicate that patients with SFD are common in general hospitals, and their direct and indirect economic burden is higher than that of non-SFD patients, which indicates that more screening effort should be made to this group to early identify their problems. Certain characteristics were identified among patients with SFD and several factors were associated with negative consequences of SFD, all of which might be prevented by developing a preventive intervention program to reduce the economic burden of the patients.
在中国，躯体形式障碍（SFD）患者常在综合医院门诊反复就医，这增加了不合理的医疗费用。对这些患者进行早期筛查并提供专科治疗以降低不必要的费用势在必行。本研究旨在使用一份新的中文问卷在综合医院筛查SFD患者，并探讨这些患者的特征和经济负担。
纳入来自三家大型综合医院神经内科、心内科和消化内科门诊的患者（n = 1497）。使用新开发的问卷“躯体症状自评问卷（SQSS）”对参与者进行筛查，以识别SFD患者（SQSS总分≥29分）。我们比较了有和没有SFD患者的人口统计学和临床信息。采用逻辑回归分析探讨与医疗费用、就诊次数和病假天数相关的潜在因素。
SFD患者的检出率为17.03%。有SFD和无SFD患者在就业情况、就诊次数、症状持续时间、医疗费用、病假天数、PHQ - 15评分和PHQ - 9评分方面存在显著差异。SFD患者常出现一般非特异性躯体症状。回归分析中，几个潜在因素与较高的医疗费用、反复就诊和病假天数相关。
研究结果表明，SFD患者在综合医院中很常见，其直接和间接经济负担高于非SFD患者，这表明应加大对该群体的筛查力度以早期识别他们的问题。已确定SFD患者的某些特征以及与SFD负面后果相关的几个因素，所有这些都可通过制定预防干预计划来预防，以减轻患者的经济负担。
