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Lebensqualität und alexithyme Merkmale bei Patienten mit somatoformer Schmerzstörung

Quality of life and alexithymia in somatoform pain disorder

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Zusammenfassung

Hintergrund

Patienten mit einer somatoformen Schmerzstörung weisen häufig eine schlechte gesundheitsbezogene Lebensqualität (QoL) und Schwierigkeiten in der Affektregulation (Alexithymie) auf. Ziel dieser Studie war es, den Zusammenhang zwischen QoL und alexithymen Merkmalen zu untersuchen.

Patienten und Methoden

Bei 51 Patienten mit somatoformer Schmerzstörung (durchschnittliche Erkrankungsdauer: 11,6 Jahre) wurden Alexithymie (TAS-20), QoL (WHOQOL-BREF), psychische Belastung und Somatisierung (SCL-90-R) und depressive Symptome (MADRS) erhoben.

Ergebnisse

Es fand sich eine signifikante negative Korrelation zwischen QoL und alexithymen Persönlichkeitsmerkmalen, insbesondere der psychischen QoL und dem TAS-20-Gesamtwert (r=−0,63, p<0,001). Die Alexithymiesubskala „Schwierigkeiten, Gefühle zu beschreiben“ erwies sich als signifikanter Einflussfaktor für die psychische QoL (β=−0,34, p<0,01), auch nach Kontrolle von Depression, Somatisierung und Geschlecht.

Schlussfolgerung

Für die insgesamt sehr niedrige QoL von Patienten mit somatoformer Schmerzstörung scheinen auch alexithyme Charakteristika eine wichtige Rolle zu spielen. Dies sollte sowohl diagnostisch als auch in der therapeutischen Zielsetzung berücksichtigt werden.

Abstract

Background

Patients with somatoform pain disorders (SPD) frequently display reduced quality of life (QoL) and increased levels of alexithymia. This study investigated the association of QoL and alexithymia in a sample of SPD.

Patients and methods

Fifty-one patients with SPD (average time since onset: 11.6 years) were assessed in terms of alexithymia (TAS-20), QoL (WHOQOL-BREF), psychological distress and somatisation (SCL-90-R), and depression (MADRS).

Results

In SPD patients a significant negative correlation was observed between QoL and alexithymia, particularly the psychological domain of QoL and the TAS-20 total score (r=–.63, p<.001). The TAS-20 subscale “Difficulty Describing Feelings” was revealed to be a significant predictor of the psychological domain of QoL (β=–.34, p<.01), even after controlling for depression, somatisation and gender.

Conclusion

Patients with SPD show a remarkably reduced QoL and alexithymia appears to play a significant role for low QoL. Clinicians need to pay careful attention to alexithymia with regard to diagnosis and treatment planning in SPD patients.

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Authors and Affiliations

  1. Psychiatrische Poliklinik, Universitätsspital Zürich, Rämistr. 100, 8091, Zürich, Schweiz

    D. Garcia Nuñez, M. Rufer, K. Leenen & J. Jenewein

  2. Psychiatrisch-Psychologischer Dienst der Stadt Zürich, Zürich, Schweiz

    K.-L. Majohr

  3. Abteilung für Psychiatrie and Psychotherapie, Universität Greifswald, Greifswald, Deutschland

    H. Grabe

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  1. D. Garcia Nuñez
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  2. M. Rufer
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  3. K. Leenen
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  4. K.-L. Majohr
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  5. H. Grabe
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  6. J. Jenewein
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Correspondence to D. Garcia Nuñez.

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Garcia Nuñez, D., Rufer, M., Leenen, K. et al. Lebensqualität und alexithyme Merkmale bei Patienten mit somatoformer Schmerzstörung. Schmerz 24, 62–68 (2010). https://doi.org/10.1007/s00482-009-0882-6

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