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Protocollaire behandeling van patiënten met onverklaarde lichamelijke klachten:

COGNITIEVE GEDRAGSTHERAPIE

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Protocollaire behandelingen in de ambulante geestelijke gezondheidszorg I

Part of the book series: CCD-Reeks ((CCD))

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Abstract

Patiënten met onverklaarde lichamelijke klachten presenteren zich veelvuldig bij hun huisarts of bij poliklinieken van algemene ziekenhuizen. Omdat de arts geen behandelbare lichamelijke aandoening kan vaststellen, worden deze patiënten vaak doorverwezen naar hulpverleners in de geestelijke gezondheidszorg. Maatschappelijk werkenden, psychologen of psychiaters kunnen daarom met deze patiënten te maken krijgen. In dit hoofdstuk wordt een cognitief-gedragstherapeutische behandeling van onverklaarde lichamelijke klachten gepresenteerd, die werd ontwikkeld en onderzocht door Speckens e.a. (1995a). Het protocol is gebaseerd op de behandeling van lichamelijke klachten zoals beschreven door Salkovskis (1989) en Sharpe, Peveler en Mayou (1992) en recenter door Nezu, Maguth-Nezu en Lombardo (2001).

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Literatuur

  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4e, herz. druk). Washington DC: APA.

    Google Scholar 

  • Bentall, R.P., Powell, P., Nye, F.J., & Edwards, R.H. (2002). Predictors of response to treatment for chronic fatigue syndrome. British Journal of Psychiatry 181, 248–252.

    Article  PubMed  Google Scholar 

  • Blankenstein, A.H., Horst, H.E. van der, Schilte, A.F., Vries, D. de, Zaat, J.O., Knottnerus, J., Eijk, J.T. van, & Haan, J. de (2002). Development and feasibility of a modified reattribution model for somatisation patients applied by their own general practitioners. Patient Education & Counseling, 47, 229–235.

    Article  Google Scholar 

  • Bouman, T.K., & Visser, S. (1998). Cognitive and behavioural treatment of hypochondriasis. Psychotherapy and Psychosomatics, 67, 214–221.

    Article  PubMed  CAS  Google Scholar 

  • Broeke, E. ten, Schurink, G., Jongh, A, de, & Korrelboom K. (2003) Gedragsexperimenten in cognitieve gedragstherapie: Een stapsgewijze beschrijving. Gedragstherapie, 36, 5–18.

    Google Scholar 

  • Clark, D.M., Salkovskis, P.M., Hackmann, A.,Wells, A., Fennell, M., Ludgate, J., Ahmad, S., Richards, H.C., & Gelder, M. (1998). Two psychological treatments for hypochondriasis. British Journal of Psychiatry, 173, 218–225.

    Article  PubMed  CAS  Google Scholar 

  • Dam, R. van, & Kraaimaat, F. (1979). Assertieve training. In: J.W.G. Orlemans, W. Brinkman, W.P. Haaijman & E.J. Zwaan (red.), Handboek voor gedragstherapie deel 1 (B7.1- B7.75). Deventer: Van Loghum Slaterus.

    Google Scholar 

  • Deale, A., Chalder, T., Marks, I., & Wessely, S. (1997). Cognitive behavior therapy for chronic fatigue syndrome: A randomized controlled trial. American Journal of Psychiatry, 154, 408–414.

    PubMed  CAS  Google Scholar 

  • Deale, A., Chalder, T., Wessely, S.C., Keijsers, G.P.J., & Hoogduin, C.A.L. (in druk). Protocollaire behandeling van patiënten met het chronische-vermoeidheidssyndroom. In: G.P.J. Keijsers, A. van Minnen & C.A.L. Hoogduin (red.), Protocollaire behandelingen in de ambulante geestelijke gezondheidszorg 2 (2e druk). Houten: Bohn Stafleu Van Loghum, Houten.

    Google Scholar 

  • Goldberg, D., Gask, L, & O'Dowd, T. (1989). The treatment of somatization: teaching techniques of reattribution. Journal of Psychosomatic Research, 33, 689–695.

    Article  PubMed  CAS  Google Scholar 

  • Greene, B., & Blanchard, E.B. (1994). Cognitive therapy for irritable bowel syndrome. Journal of Consulting and Clinical Psychology, 62, 576–582.

    Article  PubMed  CAS  Google Scholar 

  • Grol, R.P.T.M., & Orlemans, J.W.G. (1979). Ontspanningsoefeningen. In: J.W.G. Orlemans, W. Brinkman, W.P. Haaijman & E.J. Zwaan (red.), Handboek voor gedragstherapie deel 1 (B2.1-B2.44). Deventer: Van Loghum Slaterus.

    Google Scholar 

  • Hanwella, R., & Mann, A.H. (2000) Randomized controlled trial of cognitive behaviour therapy for repeated consultations for medically unexplained complaints: A feasibility study in Sri Lanka. Psychological Medicine, 30, 747–757.

    Article  PubMed  Google Scholar 

  • Hawton, K., & Kirk, J. (1986). Problem solving. In: K.E. Hawton, P.M. Salkovskis, J. Kirk, & D.M. Clark (eds.), Cognitive behaviour therapy for psychiatric problems: A practical guide (pp. 406–426). Oxford: Oxford University Press.

    Google Scholar 

  • Hellman, C., Budd, M., Borysenko, J., McClelland, D., & Bensen, H. (1990). A study of the effectiveness of two group behavioral medicine interventions for patients with psychosomatic complaints. Behavioral Medicine, 16, 165–173.

    Article  PubMed  CAS  Google Scholar 

  • Hemert, A.M. van, Hengeveld, M.W., Bolk, J.H., Rooijmans, H.G.M., & Vandenbroucke, J.P. (1993). Psychiatric disorders in relation to medical illness among patients of a general medical out-patient clinic. Psychological Medicine, 23, 167–173.

    Article  PubMed  Google Scholar 

  • Heymann-Monnikes, I., Arnold, R., Florin, I., Herda, C., Melfsen, S., & Monnikes, H. (2000). The combination of medical treatment plus multicomponent behavioral therapy is superior to medical treatment alone in the therapy of irritable bowel syndrome. American Journal of Gastroenterology, 95, 981–994.

    PubMed  CAS  Google Scholar 

  • Kashner, T.M., Rost, K., Cohen, B., Anderson, M., & Smith, G.R. (1995). Enhancing the health of somatization disorder patients: Effectiveness of short-term group therapy. Psychosomatics, 36, 462–470.

    Article  PubMed  CAS  Google Scholar 

  • Klimes, I., Mayou, R.A., Pearce, M.J., Coles, L., & Fagg, J.R. (1990). Psychological treatment for atypical non-cardiac chest pain: A controlled evaluation. Psychological Medicine, 20, 605–611.

    Article  PubMed  CAS  Google Scholar 

  • Kroenke, K., & Price, R.K. (1993). Symptoms in the community. Prevalence, classification, and psychiatric comorbidity. Archives of Internal Medicine, 153, 1474–1480.

    Article  Google Scholar 

  • Kroenke, K., & Swindle, R. (2000). Cognitive behavioural therapy for somatization and symptom syndromes: A critical review of controlled clinical trials. Psychotherapy & Psychosomatics, 69, 205–215.

    Article  CAS  Google Scholar 

  • Lange, A. (1994). Gedragsverandering in gezinnen. Groningen: Wolters-Noordhoff.

    Google Scholar 

  • Lidbeck, J. (1997). Group therapy for somatization disorders in general practice: Effectiveness of a short cognitive-behavioural treatment model. Acta Psychiatrica Scandinavica, 96, 14–24.

    Article  PubMed  CAS  Google Scholar 

  • Looper, K.I.J., & Kirmayer, L.J. (2002). Behavioral medicine approaches to somatoform disorders. Journal of Consulting and Clinical Psychology, 70, 810–827.

    Article  PubMed  Google Scholar 

  • Lloyd, A.R., Hickie, I., Brockman, A., Hickie, C., Wilson, A., Dwyer, J., & Wakefield, D. (1993). Immunologic and psychological therapy for patients with chronic fatigue syndrome: A double-blind placebo-controlled trial. American Journal of Medicine, 94, 197–203.

    Article  PubMed  CAS  Google Scholar 

  • Mayou, R., Bass, C., & Sharpe M. (1995). Overview of epidemiology, classification, and aetiology. In: R. Mayou, C. Bass & M. Sharpe (eds.), Treatment of functional somatic symptoms (pp. 42–65). Oxford: Oxford University Press.

    Google Scholar 

  • Mayou, R., Bryant, B., Sanders, D., Bass, C., Klimes, I., & Forfar, C. (1997). A controlled trial of cognitive behavioural therapy for non-cardiac chest pain. Psychological Medicine, 27, 1021–1031.

    Article  PubMed  CAS  Google Scholar 

  • McLeod, C.C., Budd, M.A., & McClelland, D.C. (1997). Treatment of somatization in primary care. General Hospital Psychiatry, 19, 251–258.

    Article  PubMed  CAS  Google Scholar 

  • Morly, S., Eccleston, C., & Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80, 1–13.

    Article  Google Scholar 

  • Nederlands Huisartsen Instituut in samenwerking met de Commissie Praktijkvoering van het Nederlands Huisartsen Genootschap (geen jaartal). Hyperventilatie.

    Google Scholar 

  • Nezu, A.M., Maguth-Nezu, C.M., & Lombardo, E.R. (2001). Cognitive behavior therapy for medically unexplained symptoms: A critical review of the treatment literature. Behavior Therapy, 32, 537–583.

    Article  Google Scholar 

  • O'Malley, P.G., Jackson, J.L., Santoro, J. Tonkins, G., Balden, E., & Kroenke, K (1999). Antidepressant therapy for unexplained symptoms and symptoms syndromes. Journal of Family Practice, 48, 980–990.

    PubMed  Google Scholar 

  • Peski-Oosterbaan, A.S. van, Spinhoven, Ph., Rood, Y. van, Does, A.J. van der, Bruschke, A.V., & Rooijmans, H.G. (1999). Cognitive behavioral therapy for noncardiac chest pain: A randomized controlled trial. American Journal of Medicine, 106, 424–429.

    Article  PubMed  Google Scholar 

  • Philips, H.C. (1987). The effects of behavioural treatment on chronic pain. Behaviour Research and Therapy, 25, 365–377.

    Article  PubMed  CAS  Google Scholar 

  • Potts, S.G., Lewin R., Fox, K.A.A., & Johnstone, E.C. (1999). Group psychological treatment for chest pain with normal coronary arteries. Quarterly Journal of Medicine, 92, 81–86.

    Article  CAS  Google Scholar 

  • Prins, J.B., Bleijenberg, G., Bazelmans, E., Elving, L., Boo, Th. de, Severens, J.L., Wilt, G.J. van der, Spinhoven, Ph., & Meer, J.W.M. van der, (2001). Cognitive behaviour therapy for chronic fatigue syndrome: A multicenter randomised controlled trial. Lancet, 357, 841–847.

    Article  PubMed  CAS  Google Scholar 

  • Rood, Y.R. van, Kuile, M.M. ter, & Speckens, A.E.M. (2001). Ongedifferentieerde somatoforme stoornis. In: Ph. Spinhoven, T.K. Bouman, & C.A.L. Hoogduin (red.), Behandelingsstrategieën bij somatoforme stoornissen (pp. 17–40). Houten/Diegem: Bohn Stafleu Van Loghum, Houten.

    Chapter  Google Scholar 

  • Salkovskis, P.M. (1989). Somatic problems. In: K.E. Hawton, P.M. Salkovskis, J. Kirk, & D.M. Clark (eds.), Cognitive behaviour therapy for psychiatric problems: A practical guide (pp. 235–276). Oxford: Oxford University Press.

    Google Scholar 

  • Sharpe, M., Hawton, K.E., Seagroatt, V., & Pasvol, G. (1992). Follow up of patients presenting with fatigue to an infectious diseases clinic. British Medical Journal, 305, 147–152.

    Article  PubMed  CAS  Google Scholar 

  • Sharpe, M., Hawton, K., Simkin, S., Surawy, C., Hackmann, A., Klimes, I., Peto, T.,Warrell, D., & Seagroatt, V. (1996). Cognitive behaviour therapy for the chronic fatigue syndrome: A randomised controlled trial. British Medical Journal, 312, 22–26.

    Article  PubMed  CAS  Google Scholar 

  • Sharpe, M., Peveler, R., & Mayou, R. (1992). The psychological treatment of patients with functional somatic symptoms: A practical guide. Journal of Psychosomatic Research, 36, 515–529.

    Article  PubMed  CAS  Google Scholar 

  • Speckens, A.E.M., Hemert, A.M. van, Spinhoven, Ph., Hawton, K.E., Bolk, J.H., & Rooijmans, H.G.M. (1995a). Cognitive behavioural therapy for medically unexplained physical symptoms: A randomised controlled trial. British Medical Journal, 311, 1328–1332.

    Article  CAS  Google Scholar 

  • Speckens, A.E.M., Hemert, A.M. van, Bolk, J., Hawton, K.E., & Rooijmans, H.G.M. (1995b). The acceptability of psychological treatment in patients with medically unexplained physical symptoms. Journal of Psychosomatic Research, 39, 855–863.

    Article  CAS  Google Scholar 

  • Speckens, A.E.M., & Rood, Y.R. van (1996). De behandeling van onverklaarde lichamelijke klachten. Directieve therapie, 16, 341–349.

    Article  Google Scholar 

  • Speckens, A.E.M., Spinhoven, Ph., Hawton, K.E., Bolk, J.H., & Hemert, A.M. van (1996). Cognitive behavioural therapy for medically unexplained physical symptoms: A pilot study. Behavioural and Cognitive Psychotherapy, 24, 1–16.

    Article  Google Scholar 

  • Sumathipala, A. Hewege, S. Hanwella, R., & Mann, A.H. (2000). Randomized controlled trial of cognitive behaviour therapy for repeated consultations for medically unexplained complaints: A feasibility study in Sri Lanka. Psychological Medicine, 30, 747–757.

    Article  PubMed  CAS  Google Scholar 

  • Toner, B.B., Segal, Z.V., Emmott, S., Myran, D., Ali, A., DiGasbarro, I., & Stuckless, N. (1998). Cognitive-behavioral group therapy for patients with irritable bowel syndrome. International Journal of Group Psychotherapy, 48, 215–243.

    PubMed  CAS  Google Scholar 

  • Vervaeke, G.A.C., Bouman T.K., & Visser, S. (in druk). Protocollaire behandeling van patiënten met hypochondrie: Cognitieve gedragstherapie. In: G.P.J. Keijsers, A. van Minnen & C.A.L. Hoogduin (red.), Protocollaire behandelingen in de ambulante geestelijke gezondheidszorg 2 (2e druk). Houten: Bohn Stafleu Van Loghum, Houten.

    Google Scholar 

  • Warwick, H.M.C., Clark, D.M., Cobb, A.M., & Salkovskis, P.M. (1996). A controlled trial of cognitive-behavioural treatment of hypochondriasis. British Journal of Psychiatry, 169, 189–195.

    Article  PubMed  CAS  Google Scholar 

  • Wessely, S., Nimnuan, C., & Sharpe, M. (1999). Functional somatic syndromes: One or many? Lancet, 354, 936–939

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. A. E. M. Speckens
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  2. Ph. Spinhoven
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  3. Y. R. van Rood
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G. P. J. Keijsers A. van Minnen C. A. L. Hoogduin

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© 2004 Bohn Stafleu Van Loghum, Houten

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Speckens, A.E.M., Spinhoven, P., van Rood, Y.R. (2004). Protocollaire behandeling van patiënten met onverklaarde lichamelijke klachten:. In: Keijsers, G.P.J., van Minnen, A., Hoogduin, C.A.L. (eds) Protocollaire behandelingen in de ambulante geestelijke gezondheidszorg I. CCD-Reeks. Bohn Stafleu van Loghum, Houten. https://doi.org/10.1007/978-90-313-7117-4_7

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  • DOI: https://doi.org/10.1007/978-90-313-7117-4_7

  • Publisher Name: Bohn Stafleu van Loghum, Houten

  • Print ISBN: 978-90-313-4249-5

  • Online ISBN: 978-90-313-7117-4

  • eBook Packages: Dutch language eBook collection

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