SOMATIZATION IN PRIMARY CARE

长期目标是了解躯体化问题， 特别是躯体化障碍，因为它发生在初级保健 设置.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 是somatizers（6-12不明原因的投诉），和2）测试一个 在另一种情况下，干预措施有效地减少了 这些患者的医疗费用过高。多中心， 前瞻性、随机、对照、单交叉临床试验将 进行。共涉及216名患者，平均分布 三个家庭的做法。将筛选和选择受试者， 他们似乎很关心。将研究三组：每组24名患者 与躯体化障碍的实践，24例患者谁是躯体化，和24 两者都不是所有患者最初将接受DIS-DSM-III-R评价 诊断、人口统计学和家庭概况、生活质量、患者 满意度、功能性健康状况和卫生保健利用率。的 将对躯体化障碍患者和躯体化者进行随机化 经过初步评估后，分为治疗组或对照组。的 治疗组患者的医生将收到一封信， 描述疾病并提出治疗建议。所有患者 然后每六个月进行一次前瞻性评估， 功能健康状况、生活质量、满意度的变化，以及 卫生保健利用。经过一年的随访， 对照组将被交叉并接受干预。另一 交叉后将对所有患者进行为期一年的定期监测。

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.