Causal illness attributions in somatoforin disorders - Associations with comorbidity and illness behavior
Causal illness attributions in somatoforin disorders - Associations with comorbidity and illness behavior
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DOI：
10.1016/j.jpsychores.2004.02.015
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发表时间：
2004-10-01
影响因子：
4.7
通讯作者：
Zech, T
中科院分区：
文献类型：
--
作者：
Rief, W;Nanke, A;Zech, T
目的：比较具有无法解释的身体症状和不同共存疾病的患者之间的因果病信念，并评估因果病信念与疾病行为的关联。方法：我们检查了 233 名在初级保健接受治疗的患者样本。纳入标准是“无法解释的身体症状”。所有患者均使用结构化访谈和自评量表[躯体症状筛查 (SOMS)、贝克抑郁量表 (BDI)、贝克焦虑量表和评估因果归因的 12 项工具] 进行调查。通过因子分析，考虑了以下疾病归因：易受感染和环境因素、心理因素、包括遗传和衰老因素在内的器质性原因以及痛苦（包括疲惫和时间压力）。结果：大多数患者报告了多种疾病归因。患者出现的躯体症状越多，他们考虑的一般解释就越多。尤其是对于脆弱性和器质性疾病信念，有躯体症状的患者得分有所提高。抑郁症和焦虑症的合并症与更多的心理归因相关。即使控制了躯体化、抑郁和焦虑的影响，疾病信念仍然与疾病行为相关。有机因果信念和脆弱性归因与医疗诊断检查的需要、症状表达的增加、疾病后果的增加和身体扫描有关。结论：多种因果归因可以共存，表明与共病抑郁症和疾病行为存在不同的关联。 (C) 2004 Elsevier Inc. 保留所有权利。
Objective: To compare causal illness beliefs between patients with unexplained physical symptoms and different comorbid disorders and to assess the association of causal illness beliefs with illness behavior. Methods: We examined a sample of 233 patients attending treatment in primary care. Inclusion criteria were "unexplained physical symptoms." All patients were investigated using structured interviews and self-rating scales [Screening for Somatoform Symptoms (SOMS), Beck Depression Inventory (BDI), Beck Anxiety Inventory, and a 12-item instrument to assess causal attributions]. By means of factor analysis, the following illness attributions were considered: vulnerability to infection and environmental factors, psychological factors, organic causes including genetic and aging factors, and distress (including exhaustion and time pressure). Results: Most patients reported multiple illness attributions. The more somatoform symptoms patients had, the more explanations in general they considered. Especially for vulnerability and organic illness beliefs, patients with somatoform symptoms had increased scores. Comorbidity with depression and with anxiety disorders was associated with more psychological attributions. Even when the influence of somatization, depression, and anxiety is controlled for, illness beliefs still showed associations with illness behavior. Organic causal beliefs and vulnerability attributions were associated with a need for medical diagnostic examinations, increased expression of symptoms, increased illness consequences, and bodily scanning. Conclusions: Multiple causal attributions can coexist demonstrating different associations with comorbid depression and illness behavior. (C) 2004 Elsevier Inc. All rights reserved.