ABSTRACT
Objective To investigate the efficacy of combination of reattribution cognitive psychotherapy and low-dose antidepressants in the treatment of ulcerative colitis (UC) complicated with functional symptoms , and to explore the psychosomatic digestive disease pattern that incorporated psychosocial variables into clinical thinking and practice .Methods From March 2016 to April 2017 ,sixty patients with UC who met the admission criteria were randomly divided into control group and observation group with 30 patients in each group .Both groups were treated with oral mesalazine ,and the observation group was further treated with reattribution cognitive psychotherapy and antidepressants . Clinical symptoms ,self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were applied to assess the efficacy at the time of enrollment and four weeks after treatment in both groups .Chi square test or t test was performed for statistical analysis .Results Among the 60 patients ,47 (78 .3％ ) met four syndromes of diagnostic criteria for phychosomatic research , and there was no statistically significant difference in the case number of each syndrome between the two groups (P> 0 .05) .After four weeks treatment ,the total effective rates of observation group and control group was 93 .3％ (28/30 ) and 53 .3％ (16/30) ,respectively ,and the difference was statistically significant (χ2 = 22 .667 ,P< 0 .05) . Before and four weeks after treatment , the SAS scores of observation group were 54 .50 ± 6 .70 and 41 .07 ± 3 .72 ,respectively ,and the difference was statistically significant (t=9 .595 ,P= 0 .005) .The SAS scores of control group were 54 .30 ± 6 .06 and 51 .90 ± 7 .92 ,respectively ,and the difference was not statistically significant (P=0 .195) .Before and four weeks after treatment ,the SDS scores of observation group were 50 .63 ± 6 .29 and 34 .40 ± 4 .58 ,respectively ,and the difference was statistically significant (t=11 .426 ,P=0 .025) .The SDS scores of control group were 50 .03 ± 6 .02 and 43 .47 ± 6 .81 ,respectively , and the difference was not statistically significant ( P= 0 .307 ) . Conclusions Psychosomatic model can significantly improve the functional symptoms complicated with UC .It is meaningful to incorporate psychosocial variables into clinical thinking and practice in psychosomatic digestive disease pattern .
ABSTRACT
Introduction Medically unexplained symptoms (MUS) are equally common and disabling across countries and cultures. Most prevalent symptoms identified in children are recurrent abdominal pain (RAP), headache, limb pain, and fatigue. Objectives To identify the presenting profile of MUS and associated features in a hospital based, nonspecialist paediatric outpatient setting. Method Randomly selected children attending the study setting were screened to identify those who fit a working definition for MUS, which specified undiagnosed symptoms being present for 3 months or more. Parents of the identified children answered an interviewer administered semi-structured questionnaire designed to investigate the profile of symptoms, their impact on the child's life, beliefs about the cause and anticipated prognosis and any associated stressful experiences in the child's life. Results 125 children (mean age 7.8 years) were identified with MUS. Commonest presenting symptoms were abdominal pain and headache. On average, 6.01 medical consultations were made for the symptoms. Difficulties with attending school and studying were the most prominent impact of the symptoms. Majority of the mothers believed that an underlying physical disorder was present, but an associated psychologically stressful experience was identified by them in 51.2% of cases. Conclusion Children with MUS warrant extended assessments for associated psychosocial and behavioural factors to enable effective management.