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Randomised Controlled Trial of a Collaborative Care Model with Psychiatric Consultation for Persistent Medically Unexplained Symptoms in General Practice

van der Feltz-Cornelis, Christina M., van Oppen, Patricia, Adèr, Herman J., van Dyck, Richard·2006·Psychotherapy and Psychosomatics

DOI 10.1159/000093949

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Abstract

Background: Patients with persistent medically unexplained symptoms often exhibit general dysfunction and psychiatric comorbidity and frequently resist psychiatric referral. The aim of this study was to evaluate the efficacy of a collaborative care model including training for general practitioners (GPs) and a psychiatric consultation model for patients with persistent medically unexplained symptoms in general practice. Method: Randomised controlled trial. Cluster randomisation at GP practices and multilevel analysis were performed. A total of 81 patients from 36 general practices completed the study. A collaborative care model of training and psychiatric consultation in general practice in the presence of the GP was compared with training plus care as usual by the GP. Outcome assessment on the patients’ well-being, functioning and utilisation of health care services was performed 6 weeks and 6 months later. Results: All the patients had somatoform disorders (Whitely Index 7.46), and 86% had comorbid psychiatric disorders. In the intervention group, the severity of the main medically unexplained symptoms decreased by 58%. The patients’ social functioning improved. The utilization of health care was lower than in the care as usual group. Conclusions: A collaborative care model combining training with psychiatric consultation in the general practice setting is an effective intervention in the treatment of persistent medically unexplained symptoms. Anxiety and depressive disorders are highly comorbid in this group. The findings warrant a larger study.

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Self-citation
Collaborative and stepped care for mental disorders: Results of a cluster-randomized controlled trial in outpatient care (the COMET study)
Heddaeus, D., Seeralan, T., Maehder, K., Porzelt, S., Daubmann, A., Dams, J., Grochtdreis, T., König, H., Knesebeck, O. V. D., Löwe, B., et al. (2025) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2025.0011 · Cited by 4
Somatoforme Störungen
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Cognitive Behavioral Therapy for Somatoform Disorders
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Symptom Presentation, Interventions, and Outcome of Emotionally-Distressed Patients in Primary Care
Fritzsche, K., Sandholzer, H., Wetzler‐Burmeister, E., Hartmann, A., Cierpka, M., Deter, H., Richter, R., Schmidt, B., Härter, M. C., Höger, C., et al. (2010) · Psychosomatics · doi:10.1016/s0033-3182(10)70720-9 · Cited by 2

Authors: van der Feltz-Cornelis, C. M., van Oppen, P., Adèr, H. J., & van Dyck, R.
Venue: Psychotherapy and Psychosomatics
Publisher: S. Karger AG
Published: 2006
Volume: 75
Issue: 5
Pages: 282-289
ISSN: 0033-3190 (ISSN-L)
1423-0348
DOI: 10.1159/000093949
OpenAlex: W2093840165
Cited by: 138
References: 42
Citations by year: 2026: 2 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 1 · 2021: 8 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 7 · 2016: 5 · 2015: 6 · 2014: 5 · 2013: 14 · 2012: 10
FWCI: 6.16
Type: journal article
Language: en
Open access: closed
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)
Locations: Psychotherapy and Psychosomatics (publishedVersion)
PubMed (publishedVersion)
UvA-DARE (University of Amsterdam) (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
Pure Amsterdam UMC (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
Keywords: somatoform disorders, collaborative care, psychiatric consultation, general practice training, psychiatric comorbidity, anxiety disorders, depressive disorders, social functioning, health care utilization, general practice
MeSH terms: Adult, Aged, Analysis of Variance, Double-Blind Method, Family Practice, Female, Humans, Inservice Training, Male, Middle Aged, Netherlands, Psychiatry, Referral and Consultation, Somatoform Disorders, Case Management

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Randomised Controlled Trial of a Collaborative Care Model with Psychiatric Consultation for Persistent Medically Unexplained Symptoms in General Practice

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