[Mental and Somatic Health Care Use in Persistent Somatic Symptoms: 4-Year Follow Up of the Network for Somatoform and Functional Disorders (Sofu-Net)]. / Psychotherapeutische und ärztliche Inanspruchnahme bei persistierenden somatischen Symptomen: 4-Jahres-Katamnese des Netzwerks für somatoforme und funktionelle Störungen (Sofu-Net).

ABSTRACT

BACKGROUND: The stepped, coordinated, interdisciplinary Health Network for Somatoform and Functional Disorders (Sofu-Net) was developed to provide guideline-based care for patients with somatoform and functional disorders. This controlled cluster cohort study evaluated patients' mental and somatic health care use, clinical outcomes, and their predictors at 4-years follow-up. METHOD: 219 patients at risk for somatoform disorders from Sofu-Net practices (n=119) and control practices (n=100) were resurveyed after 4 years using structured interviews. Outcomes were mental and somatic health care use, somatic symptom burden and depressive symptoms. RESULTS: 127 patients (n=74 Sofu-Net, n=53 controls) were followed up. Compared with the control group, Sofu-Net patients were significantly more likely to be referred to psychotherapy (55.4 vs. 35.8%). Younger age and more frequent GP consultations on the occasion of psychosocial problems predicted mental health care use. No difference was found between the two groups in the severity of clinical symptoms or in the extent of somatic health care use. Significant predictors were the number of somatic diseases, increased fear of illness, female gender, increased depressive symptomatology, low physical and mental quality of life. DISCUSSION: In the long term, the coordinated and interdisciplinary network structure succeeded in more successfully referring high-risk patients to psychotherapy. The role of the primary care physician proved to be important. However, this was not accompanied by an improvement in the patients' clinical condition or a decrease in outpatient physician utilization.