Ätiologische Faktoren bei chronischen ausgedehnten Schmerzen und/oder Fibromyalgiesyndrom: subjektive Perspektive von Patienten und Behandlern
摘要
Patients with chronic widespread pain (CWP) and/or fibromyalgia syndrome (FMS) are considered difficult to treat. Various disease models and treatment preferences exist.
ObjectiveTo assess subjective perspectives on etiological factors, disease models and treatment preferences of patients, general practitioners (GP) and psychotherapists regarding FMS/CWP.
MethodsFrom December 2019 to February 2020 questionnaires were sent to 88 patients with FMS/CWP from a neurological psychiatric practice in the Allgäu region of Germany and also to 146 GPs and 88 psychotherapists from the district. A total of 30 patients (34 %), 19 GPs (13 %) and 10 psychotherapists (11 %) participated.
ResultsNeglect, traumatization and impaired emotional awareness and/or emotional expression were predominantly named as etiologically significant. Patients, GPs and psychotherapists mainly assume a psychosomatic/psychological cause, but 67 % of patients also (tended to) assume a physical cause. For all groups, lifestyle changes and psychotherapy were therapeutically important. Patients emphasized somatic treatment approaches, while GPs in particular were in favor of psychopharmacological treatment. Those patients who assumed a psychological/psychosomatic disease model tended to consider psychopharmacological treatment and psychotherapy to be important.
ConclusionAlthough the low response rates limit the significance of the results, patients, GPs and psychotherapists, who are related to a neurological/psychiatric practice, confirmed aversive childhood experiences and impaired emotional awareness/emotional expression as etiologically important, mainly assumed a psychological/psychosomatic etiology and predominantly favored treatment in the form of lifestyle changes and psychotherapy.