Überprüfung der zeitlichen Stabilität medizinisch nicht erklärter Beschwerden und somatoformer Störungen vor dem Hintergrund unterschiedlicher Diagnosekonzepte

Zusammenfassung

Ziel dieser Untersuchung war, die Stabilität medizinisch nicht erklärter Symptome (MUS) und somatoformer Störungen vor dem Hintergrund unterschiedlicher Diagnosekonzepte (SSI4/6, DSM-IV, DSM-V) zu bestimmen und zu vergleichen. In einer 2-Phasen-Follow-up-Studie wurden 620 konsekutive Patienten mit dem PHQ-15 Fragebogen voruntersucht. In der zweiten Phase wurden 308 ausgewählte Personen ausführlich interviewt. 12 Monate später konnten 89,9% der Patienten erneut befragt werden. MUS und somatoforme Störungen wiesen schwache Stabilitätskoeffizienten auf. Für die Complex Somatic Symptom Disorder (DSM-V) fielen die Prävalenzraten geringer aus als erwartet. Innerhalb von einem Jahr gingen sie drastisch zurück. Bei der Revision somatoformer Störung im DSM-V sollte die Instabilität der Complex Somatic Symptom Disorder berücksichtigt werden. Zur Verbesserung der Stabilität sollte das Zeitkriterium um die Dauer psychischer Beschäftigung mit den Beschwerden erweitert werden.

Abstract

Objective: The aim of this study was to determine and to compare the stability of medically unexplained symptoms and somatoform disorders within the context of different diagnostic concepts (SSI4/6, DSM-IV, DSM-V).

Method: In a 2-stage follow-up study, 620 consecutive patients were first of all screened using the PHQ-15 questionnaire. In the second stage, 308 selected persons were then interviewed in detail. 12 months later, 89,9% of participants could be interviewed again.

Results: Medically unexplained symptoms and somatoform disorders showed weak stability coefficients. In regard to Complex Somatic Symptom Disorder (DSM-V), the prevalence rates were smaller than expected. Within a year, they declined drastically.

Conclusion: The instability of Complex Somatic Symptom Disorder should be taken into account when revising somatoform disorder for DSM-V. In order to improve stability, the time criterion should be extended by the duration of mental preoccupation with the ailments.

Schlüsselwörter

somatoforme Störung - Complex Somatic Symptom Disorder - Medizinisch nicht erklärte Symptome - Stabilität

Keywords

somatoform disorder - complex somatic symptom disorder - medically unexplained symptoms - stability

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