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Síntomas físicos persistentes: definición, génesis y tratamiento
Bernd Löwe1, Anne Toussaint1, Judith G M Rosmalen2
1Department of Psychosomatic Medicine and Psychotherapy, Centre for Internal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Lancet (London, England)
|June 15, 2024
Resumen
Los síntomas físicos persistentes, las quejas angustiosas que duran meses, causan una discapacidad significativa. Comprender sus complejos factores biológicos y psicosociales es clave para el tratamiento personalizado y la reducción del estigma del paciente.
Área de la Ciencia:
- Ciencias médicas
- Psicología
- Trastornos de los síntomas somáticos
Sus antecedentes:
- Los síntomas físicos persistentes (PPS) son quejas somáticas angustiosas que duran meses y causan una discapacidad y una carga sustanciales.
- Estos síntomas pueden surgir después de infecciones, lesiones o eventos estresantes, a menudo con vínculos debilitantes con una fisiopatología clara.
- Múltiples factores biológicos y psicosociales contribuyen a la persistencia de los síntomas, creando desafíos de diagnóstico y tratamiento.
Objetivo del estudio:
- Proporcionar una visión general de los síntomas físicos persistentes, abarcando su definición, causas y factores contribuyentes.
- Discutir los enfoques actuales para la gestión de la PPS, incluida la atención básica y las intervenciones específicas.
- Resaltar la necesidad de una mejor comprensión de la persistencia multifactorial para el tratamiento personalizado y la reducción del estigma.
Principales métodos:
- Revisión de la literatura y síntesis de los conocimientos actuales sobre los síntomas físicos persistentes.
- Identificación y discusión de los factores de riesgo biológicos (por ejemplo, inflamación, epigenética, desregulación) y psicosociales (por ejemplo, ansiedad, evitación).
- Examen de las estrategias de atención básica y de las intervenciones avanzadas (psicológicas, farmacológicas).
Principales resultados:
- Los síntomas físicos persistentes son complejos, influenciados por una amplia gama de mecanismos biológicos y psicosociales.
- La gestión efectiva implica la comunicación centrada en la persona, la validación, la tranquilidad y las explicaciones biopsicosociales.
- Cuando la atención básica es insuficiente, los tratamientos psicológicos y farmacológicos específicos pueden ser beneficiosos.
Conclusiones:
- Una comprensión más profunda de la naturaleza multifactorial del PPS es crucial para desarrollar tratamientos personalizados basados en mecanismos.
- Abordar los factores biológicos y psicosociales de manera integral puede mejorar los resultados de los pacientes.
- Reducir el estigma asociado con los síntomas físicos persistentes es un objetivo importante para la atención médica.
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