Zusammenfassung
Somatoforme Störungen sind für das Gesundheitssystem sowohl wegen ihrer hohen Prävalenz und auch wegen der intensiven Inanspruchnahme medizinischer Leistungen von großer Bedeutung. Auch bei psychotherapeutischen Interventionen muss dies berücksichtigt werden, da eine Normalisierung des Inanspruchnahmeverhaltens ein zentrales Behandlungsziel sein sollte. In der vorliegenden Studie wurden Häufigkeit ambulanter Arztbesuche und Variablen des Inanspruchnahmeverhaltens untersucht. Insgesamt wurden 295 Allgemeinarztpatienten mit mindestens zwei organisch nicht hinreichend begründbaren Beschwerden in die Studie aufgenommen. Psychische Störungen und die Inanspruchnahme des Versorgungssystems wurden mit einem strukturierten Interview erhoben; daneben wurden zahlreiche Fragebögen eingesetzt. Die Mehrheit (82%) der untersuchten Patienten erfüllte die Kriterien von mindestens einer somatoformen Störung. Die Anzahl der Arztbesuche in den letzten 6 Monaten belief sich im Mittel auf 15 Kontakte. Sie korrelierten mit der Anzahl somatoformer Symptome, dem Alter, Gesundheitsängsten, genereller Angst und Depressivität. Die Regressionsanalyse bestätigt nur die Symptomanzahl und das Alter als signifikante Prädiktoren des Inanspruchnahmeverhaltens. Implikationen für die Therapie dieser Patientengruppe unter besonderer Berücksichtigung des Hausarztes werden diskutiert.
Abstract
Somatoform disorders are extremely relevant for the health care system because of high prevalence rates and intensive health care utilization. In our study we investigated the frequency of GP visits and variables of health care utilization in a group of patients suffering from medically unexplained symptoms in primary care. A total of 295 patients participated—fulfilling the inclusion criteria of having at least two medically unexplained symptoms. Patients were asked to participate when they consulted their GP. Mental disorders and health care utilization were assessed with a structured interview. The majority of participants (82%) fulfilled the criteria for at least one somatoform disorder. Mean frequency of consultations of physicians was 15 during the last 6 months. Correlates of the number of doctor visits were number of somatoform symptoms, age, health anxiety, general anxiety and depression, but only the number of symptoms and age were significant predictors of health care utilization in a regression analysis. Implications for clinical practice and treatment are discussed.
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Nanke, A., Rief, W. Zur Inanspruchnahme medizinischer Leistungen bei Patienten mit somatoformen Störungen. Psychotherapeut 48, 329–335 (2003). https://doi.org/10.1007/s00278-003-0323-4
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DOI: https://doi.org/10.1007/s00278-003-0323-4