Allergiker nicht vor Psychodiagnose sicher!

Allergiker nicht vor Psychodiagnose sicher!

Beitragvon Amazone » Dienstag 9. August 2011, 16:18

Patient–Doctor Interaction, Psychobehavioural Characteristics and Mental Disorders in Patients with Suspected Allergies: Do They Predict “Medically Unexplained Symptoms”?
doi: 10.2340/00015555-1147
Abstract:
In approximately 20% of patients with suspected allergies, no organic symptom explanation can be found. Limited knowledge about patients with “medically unexplained symptoms (MUS)” contributes to them being perceived as “difficult” and being treated inadequately. This study examined the psychobehavioural characteristics of patients presenting for a diagnostic allergy work-up. Patients were interviewed and completed various self-rating questionnaires. Patient–Doctor interaction was evaluated, and the organic explicability of the patients’ symptoms was rated by allergists. Patients with vs. those without MUS differed in several respects. Mental comorbidity, female sex, dissatisfaction with care, and a problematic countertransference (the interviewer’s feelings towards the patient) independently predicted MUS. Patients whose symptoms could be explained organically reported more psychobeha­vioural problems than a control group of immuno­therapy patients. There were no differences in patient–doctor interaction. In patients with suspected allergies, recognition of psychological burden and concurrent mental disorders is important. Mental comorbidity and a difficult patient–doctor interaction may predict MUS.
Authors:
Constanze Hausteiner-Wiehle, Martine Grosber, Esther Bubel , Sylvie Groben, Susanne Bornschein , Claas Lahmann , Florian Eyer, Bernadette Eberlein, Heidrun Behrendt , Bernd Löwe, Peter Henningsen, Dorothea Huber, Johannes Ring, Ulf Darsow
Thompson AK, Juniper E, Meltzer EO. Quality of life in patients with allergic rhinitis. Ann Allergy Asthma Immunol 2000; 85: 338–347. [CrossRef]
Stauder A, Kovacs M. Anxiety symptoms in allergic patients: identification and risk factors. Psychosom Med 2003; 65: 816–823. [CrossRef]
Chida Y, Hamer M, Steptoe A. A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis. Psychosom Med 2008; 70: 102–116. [CrossRef]
Wright RJ. Stress and atopic disorders. J Allergy Clin Immunol 2005; 116: 1301–1306. [CrossRef]
Henningsen P, Zipfel S, Herzog W. Management of functional somatic syndromes. Lancet 2007; 369: 946–955. [CrossRef]
Hausteiner C, Bornschein S, Bubel E, Groben S, Lahmann C, Grosber M, et al. Psychobehavioural predictors of somatoform disorders in patients with suspected allergies. Psychosom Med 2009; 71: 1004–1011. [CrossRef]
Brand S, Heller P, Bircher A, Braun-Fahrländer C, Huss A, Niederer M, et al. Interactional behaviour as a marker for screening patients with environment-related complaints. Int J Hyg Environ Health 2007; 210: 79–89. [CrossRef]
Betan E, Heim AK, Zittel Conklin C, Westen D. Countertransference phenomena and personality pathology in clinical practice: an empirical investigation. Am J Psychiatry 2005; 162: 890–898. [CrossRef]
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient Health Questionnaire. JAMA 1999; 282: 1737–1744. [CrossRef]
Kroenke K, Spitzer RL, Williams JB. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med 2002; 64: 258–266. [CrossRef]
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–613. [CrossRef]
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092–1097. [CrossRef]
Moss-Morris R, Weinman J, Petrie K J, Horne R, Cameron LD, Buick D. The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health 2002; 17: 1–16. [CrossRef]
Fink P, Ewald H, Jensen J, Sørensen L, Engberg M, Holm M, Munk-Jørgensen P. Screening for somatisation and hypochondriasis in primary care and neurological in-patients: a seven-item scale for hypochondriasis and somatisation. J Psychosom Res 1999; 46: 261–273. [CrossRef]
Speckens AEM, Spinhoven P, Van Hemert AM, Bolk JH. The Reassurance Questionnaire (RQ): psychometric properties of a self-report questionnaire to assess reassurability. Psychol Med 2000; 30: 841–847. [CrossRef]
Noyes R Jr, Langbehn DR, Happel RL, Sieren LR, Muller BA. Health Attitude Survey. A scale for assessing somatizing patients. Psychosomatics 1999; 40: 470–478. [CrossRef]
Hahn SR. Physical symptoms and physician-experienced difficulty in the physician-patient relationship. Ann Intern Med 2001; 134: 897–904. [CrossRef]
Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med 1978; 88: 251–258. [CrossRef]
Parsons T. Definitions of health and illness in the light of American values and social structure. In: Jaco EG, editor. Patients, physicians, and illness: sourcebook in behavioural science and medicine. Glencoe, IL: Free Press, 1958: p. 165–187. [CrossRef]
Hasler G, Moergeli H, Bachmann R, Lambreva E, Buddeberg C, Schnyder U. Patient satisfaction with outpatient mental treatment: the role of diagnosis, pharmacotherapy, and perceived therapeutic change. Can J Psychiatry 2004; 49: 315–321. [CrossRef]
Waller E, Scheidt CE. Somatoform disorders as disorders of affect regulation: a development perspective. Int Rev Psychiatry 2006; 18: 13–24. [CrossRef]
Frostholm L, Fink P, Oernboel E, Christensen KS, Toft T, et al. The uncertain consultation and patient satisfaction: the impact of patients’ illness perceptions and a randomized controlled trial on the training of physicians’ communication skills, Psychosom Med 2005; 67: 897–905. [CrossRef]
Frostholm L, Oernboel E, Christensen KS, Toft T, Olesen F, Weinman J, Fink P. Do illness perceptions predict health outcomes in primary care patients? A 2-year follow-up study. J Psychosom Res 2007; 62: 129–138. [CrossRef]
Saß H, Wittchen HU, Zaudig M. Diagnostisches und Statistisches Manual Psychischer Störungen DSM-IV. Hogrefe, Göttingen 1998, p. 387, p.455, p.500 and pp. 508–528. [CrossRef]
Fortune G, Barrowclough C, Lobban F. Illness representations in depression. Br J Clin Psychol 2004; 43: 347–364. [CrossRef]
Quiles Marcos Y, Terol Cantero MC, Romero Escobar C, Pagán Acosta G. Illness perception in eating disorders and psychosocial adaptation. Eur Eat Disord Rev 2007; 15: 373–384. [CrossRef]
Nimnuan C, Hotopf M, Wessely S. Medically unexplained symptoms: an epidemiological study in seven specialities. J Psychosom Res 2001; 51: 361–367. [CrossRef]
Kroenke K. Patients presenting with somatic complaints: epidemiology, mental comorbidity and management. Int J Methods Psychiatr Res 2003; 12: 34–43. [CrossRef]


http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1147
Amazone
Forenlegende
 
Beiträge: 1560
Registriert: Dienstag 6. Februar 2007, 14:50

Allergiker nicht vor Psychodiagnose sicher!

Beitragvon Flaunt » Dienstag 9. August 2011, 16:25

Ja, das dachte man Anfang des 19. Jahrhunderts, dass Allergien psychisch bedingt seien.
Flaunt
Durchstarter
 
Beiträge: 169
Registriert: Sonntag 25. Juli 2010, 10:41

Allergiker nicht vor Psychodiagnose sicher!

Beitragvon Clarissa » Dienstag 9. August 2011, 16:55

ist euch auch schon mal aufgefallen das die welt in vielen punkten seit einiger zeit wieder rückwärts geht und das betrifft nicht nur die medizin!
Und allen Leugnern zum Trotz, im DIMDI
ICD-10-GM Version 2018 - Stand Oktober 2017 ist MCS immer noch im Thesaurus unter
T 78.4 zu finden und wirklich nur dort und an keiner anderen Stelle!
Benutzeravatar
Clarissa
Prof. Forum
 
Beiträge: 6492
Registriert: Montag 9. Januar 2006, 18:00


Zurück zu Goldene Zitrone der Umweltmedizin

Wer ist online?

Mitglieder in diesem Forum: 0 Mitglieder und 10 Gäste