Speckens A E, Van Hemert A M, Bolk J H, Rooijmans H G, Hengeveld M W
Department of Psychiatry, University Hospital Leiden, The Netherlands.
Psychol Med. 1996 Jul;26(4):745-52. doi: 10.1017/s0033291700037764.
The aim of the study was to investigate the recovery and frequency of physician contact in patients with unexplained physical symptoms and to identify factors associated with persistent disorder. Of 100 consecutive patients who presented with medically unexplained symptoms to a general medical out-patient clinic, 81 participated in a follow-up study. The mean follow-up time was 15.2 months (S.D. 4.0). At follow-up, many of the patients with unexplained physical symptoms reported that they had recovered (30%) or improved (46%) with regard to their presenting symptoms. Female sex and a high number of symptoms predicted a bad outcome in terms of recovery. Persistence of symptoms was not related to the duration of the symptoms, type of presenting complaint or the presence of psychiatric disorder. Forty per cent of patients with unexplained symptoms did not visit their general practitioner on their own initiative in the year following the initial visit to the clinic. Medical care utilization appeared to be associated with female sex, age, number and duration of symptoms, fatigue and psychiatric disorder, especially somatoform disorders. However, the association of a high frequency of physician contact with female sex and psychiatric disorder was not sustained after controlling for possible confounding factors.
该研究的目的是调查有不明原因身体症状患者的康复情况及与医生联系的频率，并确定与持续性疾病相关的因素。在一家普通内科门诊就诊的100例连续出现医学上无法解释症状的患者中，81例参与了一项随访研究。平均随访时间为15.2个月（标准差4.0）。随访时，许多有不明原因身体症状的患者报告称，就其出现的症状而言，他们已经康复（30%）或有所改善（46%）。女性和出现大量症状预示着康复方面的不良结果。症状的持续与症状持续时间、主诉类型或精神障碍的存在无关。40%有不明原因症状的患者在首次就诊诊所后的一年里没有主动去看全科医生。医疗服务利用似乎与女性、年龄、症状数量和持续时间、疲劳及精神障碍有关，尤其是躯体形式障碍。然而，在控制了可能的混杂因素后，医生联系频率高与女性及精神障碍之间的关联并不持续。
