Clinical and patient satisfaction outcomes of a new treatment for somatized mental disorder taught to general practitioners.

摘要

BACKGROUND: Patients with mental disorder presenting with medically unexplained symptoms (somatized mental disorder) are common in primary care, difficult to treat, and function poorly in their daily lives. AIM: To examine the effects on patient outcome and satisfaction of a training package for somatized mental disorder delivered to general practitioners (GPs). METHOD: A prospective study of a before-and-after training study of different cohorts of patients attending eight GPs who acted as their own controls. Patients were stratified according to their belief that the presenting medical symptom had either a partial or completely physical cause. RESULTS: One hundred and three patients in the cohort before training, and 112 patients in the cohort after training, were diagnosed with somatized mental disorder by the study GPs. After training there were significant improvements in interview-rated psychiatric disorder (P = 0.032) at one month, self-rated psychiatric disorder (P = 0.024), and global function (P = 0.020) at three months in patients who believed their symptoms to have a partial physical cause. Training at one-month follow-up reduced depressive symptoms in patients with major depression but did not significantly change any other outcome in patients who believed their symptoms had only a physical cause. There was no overall change in patient satisfaction. CONCLUSION: Training GPs clinically benefited patients with somatized mental disorder who believe that their symptoms have a partial physical cause.