SOMATIZATION IN PRIMARY CARE

长期目标是了解躯体化的问题，以及 尤其是躯体化障碍，因为它发生在初级保健 布景。具体目标是：1)记录患病率和概况 躯体化障碍患者的特点及其与躯体化障碍的关系 是躯体化药物(6-12个原因不明的投诉)，以及2)测试 在另一种情况下显示的干预措施在减少 这些患者的医疗费用过高。一个多中心， 前瞻性、随机、对照、单交叉临床试验将 共涉及216名平均分布的病人。 在三个家庭实践之间。受试者将被筛选和选择为 他们似乎是为了照顾。将进行三组研究：每组24名患者 24名躯体化障碍患者和24名躯体化障碍患者 他们都不是。所有患者将接受DIS-DSM-III-R初步评估 诊断、人口统计和家庭概况、生活质量、患者 满意度、功能健康状况和卫生保健利用率。这个 躯体化障碍患者和躯体化药物将被随机分配 在初步评估为治疗组或对照组后。这个 治疗组患者的医生将收到一封信 描述混乱情况，并提出管理建议。所有患者 然后每六个月进行一次前瞻性的评估 功能健康状况、生活质量、满意度和 卫生保健利用情况。经过一年的随访，治疗后的患者 对照组将被交换并接受干预。另一个 所有患者的定期监测将在一年后进行交叉。

The long-term objectives are to understand the problem of somatization, and particularly somatization disorder, as it occurs in the Primary care setting. The specific aims are: 1) to document the prevalence and profile the characteristics of patients with somatization disorder and patients who are somatizers (6-12 unexplained complaints), and 2) to test an intervention shown in another setting to be effective in reducing the excessive health care expenditures of these patients. A multicenter, prospective, randomized, controlled, single-crossover clinical trial will be undertaken., involving a total of 216 patients distributed equally between three family practices. Subjects will be screened and selected as they appear for care. Three groups will be studied: 24 patients from each practice with somatization disorder, 24 patients who are somatizers, and 24 who are neither. All patients will be evaluated initially for DIS-DSM-III-R diagnoses, demographic and family profile, quality of life, patient satisfaction, functional health status, and health care utilization. The patients with somatization disorder and the somatizers will be randomized after initial evaluation into either a treatment or control group. The physicians of the patients in the treatment group will receive a letter describing the disorder and making management recommendations. All patients will then be followed prospectively with evaluations every six months for changes in functional health status, quality of life, satisfaction, and health care utilization. After one year of followup, the patients in the control groups will be crossed over and receive the intervention. Another year of periodic monitoring of all patients will follow the crossover.