Illness Perception Status In Patients With Somatic Symptom Disorder And Clinical Solutions

Somatic symptom disorder is a new diagnostic term in the fifth edition of the American Diagnostic and Statistical Manual of Mental Diseases.Patients with this disease often consult clinical departments of general hospitals,with single or multiple somatic symptoms as their main complaint.Patients have high levels of concern about their physical symptoms and anxiety about their health.They visit different hospitals repeated and form a special mode of visiting the doctor--"doctor shopping" mode.This mode of visiting doctor is closely related to patients’ illness perception.Illness perception is a disease belief that a patient holds on a disease or symptom based on personal knowledge and experience,it largely determines the patient’s behavior orientation in disease management.Illness perception also affects the individual’s emotional response and its coping behavior to the disease directly,such as treatment adherence.And the higher the patients’ negative cognitive level of disease,the more negative their recovery and prognosis.SSD patients are particularly prominent in this regard.Therefore,in the whole course management of SSD patients,early improvement of disease cognition is important for improving treatment compliance,reducing recurrence rate,and disease rehabilitation.However,work experience in general hospitals is very limited.This study was designed to investigate the characteristics and influencing factors of disease cognition in SSD patients in general hospitals,and to explore an effective clinical solution.The research methods in this paper include:(1)15 newly diagnosed and untreated SSD inpatients were selected in general hospitals.According to the qualitative research method,an interview outline was designed and semi-structured interviews were conducted to further understand the patients’ perception and beliefs about the disease.(2)110 SSD patients in general hospitals were assessed by self-made disease cognitive questionnaire,symptom checklist 90,Eysenck personality questionnaire and event-related potential test.Linear regression and other statistical methods were used to analyze the status of disease cognitive and influencing factors.(3)Based on the theoretical basis of supportive psychotherapy technology and structural group therapy technology,explored a new type of clinical solution-structured group psychological ward round.(4)There were 55 SSD patients in the study group and 55 in the controlgroup.The control group only participated in routine ward rounds and treatment.The study group participated in structured group psychological ward rounds besides routine ward rounds and treatment.The follow-up efficacy and compliance were analyzed statistically.The results of this study are as follows:(1)According to the results of qualitative research,we summarized the patients’ perception of illness as follows: first,symptom recognition,such as denying that the physical symptoms are not a mental disease,low understanding of the disease;second,medication concerns,such as worrying about side effects of drugs,worrying about drug addiction,and the difficulty of adhering to long-term regular medication;third,emotional reaction,depression and helplessness are obvious.And a “illness perception questionnaire” was extracted according to the research results.(2)The analysis of disease cognitive status and influencing factors showed that,most patients have poor illness perception,and personality characteristics such as introverted and extroverted,mental health status such as the degree of somatization,the degree of anxiety,as well as brain evoked potentials such as p300 component,p50 component,and MMN component can affect the patient’s illness perception level.(3)To explore a kind of psychological education mode suitable for inpatients in general hospitals--structural group psychological ward rounds,aiming at improving the patients’ perception,including the identification of the symptoms and the understanding of causes of SSD,the difference and relationship between somatic symptoms and emotional disorders,information on drugs,psychotherapy and relapse.(4)The results of comparison between the study group and the control group showed that,the patients who participated in the structural group psychological ward rounds had more obvious improvement in disease awareness,and the clinical solution probably had a long-term effect in improving compliance and curative effect.In this study,we used qualitative research methods to deeply understand the characteristics of disease cognition of SSD patients in general hospitals,and analyzed the influence of personality factors,mental health status and brain evoked potentials on disease cognition.We explored an effective clinical solution suitable for general hospitals,and found that the program can significantly improve illness perception and probably had long-term effects to improve patients’ compliance and efficacy.