患者的心理健康和躯体症状负担

Arnold Bobrowski, Jan Porthun
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摘要

背景--研究结果表明,功能性躯体障碍受生物学、心理学和行为学的影响。方法 - 作为两次问卷调查研究的一部分,对柏林 OSD 骨科教学实践中的患者进行了调查。在第一次调查(121 人)的基础上,计算了符合焦虑和抑郁(HADS-D)临界标准的频率,并确定了慢性疼痛(CPG)严重程度的分布。在第二轮(n = 167)中,计算了生物心理社会压力(KPD-38)的平均值。通过使用 SSS-8 和 SSD-12 的临界标准,根据 DSM-V 进行了躯体应激障碍筛查。此外,还对选定的社会心理、行为和躯体量表以及症状持续时间和年龄进行了相关性测试。结果 - 目前的躯体不适症状平均持续了约 5.6 年(中位数为 3 年)。研究参与者最常感到疲劳或乏力(29.4%),其次是背痛(28.2%)和四肢疼痛(17.4%)。12.6%的研究参与者符合躯体应激障碍的标准。社会心理或行为方面的因素与躯体损伤方面的因素之间存在明显的相关性。结论 - 研究结果表明,骨科教学实践中的患者主要患有慢性病,这些慢性病既表现在身体层面,也表现在社会心理和行为层面,而且这些层面之间存在明显的联系。
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Psychische Gesundheit und somatische Symptombelastung von Patient*innen

Background – Research results show that functional somatic disorders are subject to biological, psychological and behavioural influences. In the field of osteopathy, the symptom burden of patients has not been sufficiently studied from a multidimensional perspective.

Methods – As part of a questionnaire study with two runs, patients in the osteopathic teaching practice of OSD Berlin were surveyed. Based on the first run (n = 121), the frequency of fulfilled cut-off criteria for anxiety and depression (HADS-D) was calculated and the distribution to the severity levels of chronic pain (CPG) was determined. For the second run (n = 167), average values for biopsychosocial stress (KPD-38) were calculated. Screening for somatic stress disorder according DSM-V was performed by using cut-off criteria for SSS-8 and SSD-12. Moreover, a correlation test was carried out between selected psychosocial, behavioural and physical scales as well as the duration of symptoms and the age.

Results – The current physical complaints persisted for an average of about 5.6 years (median – 3 years). The study participants most often feel severely to very severely impaired by fatigue or lack of energy (29.4 %), followed by back pain (28.2 %) and pain in the extremities (17.4 %). 12.6 % of the study participants met the criteria for somatic stress disorder. Significant correlations were shown between factors of the psychosocial or behavioural dimension and the physical impairment dimension. Furthermore, 22,3 % of the first run showed a clear anxiety issue and the anxiety cut-off-criteria were met more frequently with an increasing degree of pain chronification.

Conclusion – The results indicate that the patients in the osteopathic teaching practice mainly suffer from chronic complaints that manifest themselves on a physical as well as on a psychosocial and behavioural level, and that there are clear connections across these levels.

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