TY - JOUR
KW - Adult
KW - Combined Modality Therapy
KW - Family Practice/statistics & numerical data
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Outcome and Process Assessment (Health Care)
KW - Patient Care Team
KW - Personality Assessment/statistics & numerical data
KW - Personality Inventory/statistics & numerical data
KW - Primary Health Care/utilization
KW - Psychometrics/statistics & numerical data
KW - Psychotherapy
KW - Reproducibility of Results
KW - Sick Role
KW - Somatoform Disorders/epidemiology/psychology/therapy
KW - Statistics as Topic
KW - Utilization Review
AU - A. M. Kolk
AU - S. Schagen
AU - G. J. Hanewald
A1 - 
AB - OBJECTIVES: To test the effect of psychological intervention on multiple medically unexplained physical symptoms, psychological symptoms, and health care utilization in addition to medical care as usual. To identify patient-related predictors of change in symptoms and care utilization. METHODS: In a randomized controlled trial, subjects were assigned to one of two conditions: psychological intervention by a qualified therapist plus care as usual by a general practitioner (GP) or care as usual only. Participants (N=98) were administered a standardized interview and several outcome measures at intake and after 6 months and 12 months after intake. GPs rated medically unexplained and explained symptoms and consultations over a period of 1 1/2 years. RESULTS: ANOVAs for repeated measures showed that self-reported and GP-registered unexplained physical symptoms decreased from pretest to posttest to follow-up. Psychological symptoms and consultations decreased from pretest to posttest. GP-registered explained symptoms did not decrease. However, intervention and control groups did not differ in symptom reduction. Path analysis revealed two paths to a decrease in self-reported unexplained physical symptoms: from more negative affectivity via more psychological attribution and more pretreatment anxiety, and from more somatic attribution via more psychological attribution and more pretreatment anxiety. CONCLUSION: Intervention and control groups did not differ in symptom reduction. Reduction of self-reported medically unexplained symptoms was well predicted by patient-related symptom perception variables, whereas the prediction of change in registered symptoms and consultations requires a different model.
BT - Journal of psychosomatic research
C5 - Healthcare Disparities; Medically Unexplained Symptoms
CP - 4
CY - England
DO - 10.1016/j.jpsychores.2004.02.012
IS - 4
JF - Journal of psychosomatic research
N2 - OBJECTIVES: To test the effect of psychological intervention on multiple medically unexplained physical symptoms, psychological symptoms, and health care utilization in addition to medical care as usual. To identify patient-related predictors of change in symptoms and care utilization. METHODS: In a randomized controlled trial, subjects were assigned to one of two conditions: psychological intervention by a qualified therapist plus care as usual by a general practitioner (GP) or care as usual only. Participants (N=98) were administered a standardized interview and several outcome measures at intake and after 6 months and 12 months after intake. GPs rated medically unexplained and explained symptoms and consultations over a period of 1 1/2 years. RESULTS: ANOVAs for repeated measures showed that self-reported and GP-registered unexplained physical symptoms decreased from pretest to posttest to follow-up. Psychological symptoms and consultations decreased from pretest to posttest. GP-registered explained symptoms did not decrease. However, intervention and control groups did not differ in symptom reduction. Path analysis revealed two paths to a decrease in self-reported unexplained physical symptoms: from more negative affectivity via more psychological attribution and more pretreatment anxiety, and from more somatic attribution via more psychological attribution and more pretreatment anxiety. CONCLUSION: Intervention and control groups did not differ in symptom reduction. Reduction of self-reported medically unexplained symptoms was well predicted by patient-related symptom perception variables, whereas the prediction of change in registered symptoms and consultations requires a different model.
PP - England
PY - 2004
SN - 0022-3999; 0022-3999
SP - 379
EP - 389
EP - 
T1 - Multiple medically unexplained physical symptoms and health care utilization: outcome of psychological intervention and patient-related predictors of change
T2 - Journal of psychosomatic research
TI - Multiple medically unexplained physical symptoms and health care utilization: outcome of psychological intervention and patient-related predictors of change
U1 - Healthcare Disparities; Medically Unexplained Symptoms
U2 - 15518674
U3 - 10.1016/j.jpsychores.2004.02.012
VL - 57
VO - 0022-3999; 0022-3999
Y1 - 2004
ER -