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High-utilizing Crohn's disease patients under psychosomatic therapy*

机译：高水平克罗恩病患者的心身疗法*

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Objective Few studies have been published on health care utilization in Crohn's disease and the influence of psychological treatment on high utilizers. Methods The present sub study of a prospective multi center investigation conducted in 87 of 488 consecutive Crohn's disease (CD) patients was designed to investigate the influence of the course of Crohn's disease on health care utilization (hospital days (HD) and sick leave days (SLD) collected by German insurance companies) and to examine the conditions of high-utilizing patients. Predictors of health care utilization should be selected. Based on a standardized somatic treatment, high health care utilizing patients of the psychotherapy and control groups should be compared before and after a one-year treatment. Results Multivariate regression analysis identified disease activity at randomization as an important predictor of the clinical course (r2 = 0.28, p 2 = 0.15, p = 0.09). The patients' level of anxiety, depression and lack of control at randomization predicted their health-related quality of life at the end of the study (r2 = 0.51, p 2 = 0.22, p Among high utilizers, a significantly greater drop in HD (p Conclusion The course of Crohn's disease is influenced by psychological as well as somatic factors; especially depression seems important here. A significant drop of health care utilization demonstrates the benefit of psychological treatment in the subgroup of high-utilizing CD patients. Further studies are needed to replicate the findings of the clinical outcome in this CD subgroup.
机译：目的很少有关于克罗恩病医疗保健利用以及心理治疗对高利用者的影响的研究的发表。方法本子研究对488例连续的克罗恩病（CD）患者中的87名进行了一项前瞻性多中心调查，旨在研究克罗恩病病程对医疗保健利用率（医院日（HD）和病假日（ SLD）由德国保险公司收集）并检查高利用率患者的状况。应该选择卫生保健利用率的预测指标。基于标准化的躯体治疗，应在一年治疗前后比较采用心理治疗和对照组患者的高水平医疗保健。结果多元回归分析确定随机分组的疾病活动是临床病程的重要预测指标（r 2 = 0.28，p 2 = 0.15，p = 0.09）。在研究结束时，患者的焦虑，抑郁和缺乏控制的水平预测了他们在研究结束时与健康相关的生活质量（r 2 = 0.51，p 2 = 0.22， p在高使用率人群中，HD的下降幅度更大（p结论克罗恩病的病程受心理和躯体因素的影响;在这里抑郁症显得尤为重要。医疗保健利用率的显着下降证明了心理治疗对患者的益处。 CD患者亚组，需要进一步的研究来复制该CD亚组临床结果的发现。

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