Coordination Funds

持续性躯体症状(PSS)在所有医学领域都非常普遍；它们使患者致残，并给社会带来高昂的代价。主观症状负担与潜在疾病的严重程度相关性较差，患者对有效和量身定做的治疗的需求远未得到满足。有初步证据表明，除了疾病特有的病理生理过程外，对症状严重性的预期、躯体感觉放大和既往疾病经历等心理因素也有助于功能性和躯体疾病中的症状持久性。然而，特别是对于躯体疾病，缺乏综合了病理生理、心理和社会因素的前瞻性研究，研究从急性到慢性躯体症状的转变。更好地了解症状持续的多因素机制对于制定有效预防和治疗PSS的有针对性的干预措施至关重要。这个跨学科研究小组的总体目标是确定一系列内科疾病中症状持续的一般和疾病特定的危险因素和病因学机制，从而为PSS的循证干预奠定基础。其他目标包括开发PSS的多变量预测模型、跨疾病慢性轨迹的机制比较、通用和疾病特定风险分数的推导以及风险因素的修改。8个项目将在总共4044名10种不同医疗条件的患者中调查特定的风险因素和症状持续的机制。所有研究设计都是前瞻性的，并共享共同的评估点、核心工具和结果变量，以便能够比较和验证不同项目和疾病的结果。第一个四年资助阶段的研究将侧重于确定与不良症状病程有关的一般机制和疾病具体机制。前瞻性多变量预测模型的发展将有助于理解跨疾病的PSS的过程。在第二个四年资助阶段，除了复制和验证第一个资助阶段的结果外，我们还将对最有希望识别的风险因素进行实验修改，以改善临床结果。预期影响：这个跨学科研究单位将从根本上拓宽我们对各种疾病躯体症状的发展和持续的了解。对这些机制的全面了解将有助于更早地认识到有风险的患者，并为跨疾病的PSS制定预防和量身定制的治疗概念。因此，它将为改善受PSS影响的人的医疗保健和生活质量奠定基础。

Persistent Somatic Symptoms (PSS) are highly prevalent in all areas of medicine; they are disabling for patients and costly for society. The subjective symptom burden correlates poorly with the severity of the underlying disease, and patients’ needs for effective and tailored treatment are far from being met. There is initial evidence indicating that, in addition to disease-specific pathophysiological processes, psychological factors such as expectations of symptom severity, somatosensory amplification, and prior illness experiences contribute to symptom persistence in functional as well as in somatic diseases. However, especially for somatic diseases, there is a lack of prospective studies investigating the transition from acute to chronic somatic symptoms, integrating pathophysiological, psychological, and social factors. A better understanding of the multifactorial mechanisms of symptom persistence is crucial in order to develop targeted interventions for effective prevention and treatment of PSS.The overall aim of this interdisciplinary Research Unit is to identify generic and disease-specific risk factors and aetiological mechanisms of symptom persistence across a range of medical diseases, and thereby create a foundation for evidence-based interventions for PSS. Additional aims include the development of multivariate prediction models for PSS, the comparison of mechanisms for a chronic trajectory across diseases, the derivation of generic and disease-specific risk scores, and the modification of risk factors.Eight projects will investigate specific risk factors and mechanisms of symptom persistence in a total of 4044 patients with ten different medical conditions. All study designs are prospective and share common assessment points, core instruments, and outcome variables in order to allow comparison and validation of results across projects and diseases. Research in the first four-year funding phase will focus on the identification of generic and disease-specific mechanisms associated with unfavourable symptom course. The development of a prospective multivariate prediction model will facilitate the understanding of the course of PSS across diseases. In the second four-year funding phase, we will, apart from replicating and validating of the findings from the first funding phase, experimentally modify the most promising identified risk factors in order to improve clinical outcomes.Expected impact: This interdisciplinary Research Unit will fundamentally broaden our understanding of the development and persistence of somatic symptoms across various diseases. Comprehensive knowledge of these mechanisms will contribute to earlier recognition of patients at risk, and to the development of prevention and tailored treatment concepts for PSS across diseases. It will thereby create a foundation for improving medical care and quality of life of those affected by PSS.