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[Bio-psychosocial treatment approach to somatizing patients in primary care: a pilot study]
J M Aiarzaguena1, G Grandes, I Alonso-Arbiol
1Especialista en Medicina Familiar y Comunitaria. Unidad de Investigacion de Atencion Primaria. Osakidetza, Bilbao, Spain. jaiarzaguenas@meditex.es
Objective:
To explore the feasibility of a brief psychosocial intervention for somatizing patients in the Primary Care setting and its potential effects on these patients' quality of life.
Design:
Prospective series of 12 cases, with pre and post-intervention analyses.Setting. Three general practices of the Basque Health Service.
Patients:
Consecutive sample of 12 patients, between 18 and 65 years-old, complaining about at least six medically unexplained symptoms for female patients or at least four for male patients. Intervention and measurement. DEPENAS intervention was carried out: Detection- Explanation-Plan-Exploration- Normalization-Action-Follow-up. Differences between before- and after-intervention health-related quality of life (SF-36) were compared and group interviews were held with the three collaborator general practitioners.
Results:
Overall quality of life improvement was estimated in 8 points (SD, 13.4; P =.073). Intra-GP correlation coefficients, necessary for estimate the size of the clinical trial, were null for five scales, and 0.058, 0.098 and 0.28 for the other three scales. Group interviews showed that DEPENAS bio-psycho-social intervention is acceptable for general practitioners and that there was a high risk of contamination when the same doctor simultaneously treated some patients and not others.
Conclusions:
The improvement seen after the intervention, although not totally attributable to it due to the lack of a control group, justify the need of conducting a clinical controlled trial randomised by GPs to avoid contamination.