Coordination Funds

持续性躯体症状（PSS）在所有医学领域都非常普遍；它们不仅使病人致残，而且使社会付出高昂的代价。主观症状负担与基础疾病的严重程度相关性较差，患者对有效和针对性治疗的需求远未得到满足。有初步证据表明，除了疾病特异性病理生理过程外，心理因素，如对症状严重程度的预期、体感放大和既往疾病经历，也有助于功能性疾病和躯体疾病的症状持续性。然而，特别是对于躯体疾病，缺乏从急性到慢性躯体症状转变的前瞻性研究，整合病理生理、心理和社会因素。更好地了解症状持续的多因素机制对于制定有针对性的干预措施以有效预防和治疗PSS至关重要。这个跨学科研究单位的总体目标是确定一系列医学疾病的一般和特定疾病的风险因素和症状持续的病因机制，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，比较疾病慢性轨迹的机制，推导通用和疾病特异性风险评分，以及修改风险因素。8个项目将调查共有4044名患有10种不同疾病的患者的具体风险因素和症状持续机制。所有的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，以便对项目和疾病之间的结果进行比较和验证。第一个四年资助阶段的研究将侧重于确定与不利症状病程相关的一般和特定疾病机制。前瞻性多变量预测模型的建立将有助于了解PSS的跨疾病病程。在第二个为期四年的资助阶段，除了复制和验证第一个资助阶段的发现外，我们还将通过实验修改最有希望确定的风险因素，以改善临床结果。预期影响：这个跨学科的研究单位将从根本上拓宽我们对各种疾病的躯体症状的发展和持续的理解。对这些机制的全面了解将有助于更早地识别处于危险中的患者，并有助于制定跨疾病PSS的预防和量身定制的治疗概念。因此，它将为改善PSS患者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.