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Regular Article

Randomised Controlled Trial of a Collaborative Care Model with Psychiatric Consultation for Persistent Medically Unexplained Symptoms in General Practice

van der Feltz-Cornelis C.M.a, d · van Oppen P.b, d · Adèr H.J.c, d · van Dyck R.b, d

Author affiliations

aNetherlands Institute of Mental Health and Addiction, Utrecht, Departments of bPsychiatry, cClinical Epidemiology and Biostatistics, and dInstitute for Research in Extramural Medicine, VU Medical Centre/GGZ Buitenamstel, Amsterdam, The Netherlands

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Psychother Psychosom 2006;75:282–289

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: August 10, 2006
Issue release date: August 2006

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

Abstract

Background: Patients with persistent medically unexplained symptoms often exhibit general dysfunction and psychiatric comorbidity and frequently resist psychiatric referral. The aim of this study was to evaluate the efficacy of a collaborative care model including training for general practitioners (GPs) and a psychiatric consultation model for patients with persistent medically unexplained symptoms in general practice. Method: Randomised controlled trial. Cluster randomisation at GP practices and multilevel analysis were performed. A total of 81 patients from 36 general practices completed the study. A collaborative care model of training and psychiatric consultation in general practice in the presence of the GP was compared with training plus care as usual by the GP. Outcome assessment on the patients’ well-being, functioning and utilisation of health care services was performed 6 weeks and 6 months later. Results: All the patients had somatoform disorders (Whitely Index 7.46), and 86% had comorbid psychiatric disorders. In the intervention group, the severity of the main medically unexplained symptoms decreased by 58%. The patients’ social functioning improved. The utilization of health care was lower than in the care as usual group. Conclusions: A collaborative care model combining training with psychiatric consultation in the general practice setting is an effective intervention in the treatment of persistent medically unexplained symptoms. Anxiety and depressive disorders are highly comorbid in this group. The findings warrant a larger study.

© 2006 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: August 10, 2006
Issue release date: August 2006

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS


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