Collaborative stepped care for somatoform disorders: A pre-post-intervention study in primary care.

Area of Science:

• Psychiatry
• Primary Care Medicine
• Health Services Research

Background:

• Somatoform disorders pose management challenges in primary care due to diagnostic difficulties and delayed treatment.
• Existing healthcare models often result in fragmented care and suboptimal patient outcomes.

Purpose of the Study:

• To assess the feasibility of an interdisciplinary collaborative care network for somatoform disorders.
• To evaluate the network's impact on diagnostic processes and treatment strategies in primary care settings.

Main Methods:

• The Network for Somatoform and Functional Disorders (Sofu-Net) connected primary care physicians (PCPs), psychotherapists, and mental health clinics.
• High-risk patients were identified using the Patient Health Questionnaire and assessed pre- and post-network establishment.
• Key outcomes included discussion of psychosocial distress, diagnostic rates, and treatment recommendations.

Main Results:

• High-risk patients more frequently discussed psychosocial distress with PCPs after network implementation (63.3% vs. 79.2%).
• PCPs increased antidepressant prescriptions (3.8% vs. 25.2%) and decreased benzodiazepine use (21.8% vs. 6.5%).
• The network did not significantly alter diagnostic detection rates or psychotherapy referral recommendations.

Conclusions:

• An interdisciplinary network for somatoform disorders is feasible and demonstrates potential benefits.
• Collaborative care models can enhance doctor-patient communication and refine prescribing practices for these disorders.