Rainer Schaefert

Rainer Schaefert
Universität Heidelberg · Department of Internal Medicine II, General Internal Medicine and Psychosomatics

MD

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90
Publications
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Publications

Publications (90)
Article
Background: Collaborative group intervention (CGI) in patients with functional somatic syndromes (FSS) has been shown to improve mental quality of life. Objective: To analyse incremental cost-utility of CGI compared to enhanced medical care in patients with FSS. Methods: An economic evaluation alongside a cluster-randomised controlled trial wa...
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Objective: We researched associations between somatic symptom severity (SSS), physical and psychological factors in Chinese breast cancer patients. Methods: This multicenter cross-sectional study enrolled 255 Chinese breast cancer patients of different stages and treatment phases. They answered standard instruments assessing SSS (PHQ-15), depres...
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Objective: To assess the efficacy, tolerability, and safety of hypnosis in adult irritable bowel syndrome by a meta-analysis of randomized controlled trials. Methods: Studies were identified by a literature search of the databases Allied and Complementary Medicine Database, Central Register of Controlled Trials, Cumulative Index to Nursing and A...
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Objective Irritable bowel syndrome (IBS) is a chronic disease leading to abdominal pain that is often related to psychological distress. The aim of the study was to investigate the temporal relationships between abdominal pain and psychological variables in patients with IBS. Methods This longitudinal diary study included eight patients from a wai...
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Background The coronavirus disease 2019 (COVID-19) pandemic was accompanied by new challenges for psychosocial health care to enable the support of affected patients, their families, and staff in general hospitals. In this study, we aimed to describe the structures and procedures put in place by psychosomatic, psychiatric, and psychological consult...
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Background: Single-nucleotide polymorphisms (SNPs) of the serotonin type 3 receptor subunit (HTR3) genes have been associated with psychosomatic symptoms, but it is not clear whether these associations exist in irritable bowel syndrome (IBS). Aim: To assess the association of HTR3 polymorphisms with depressive, anxiety, and somatization symptoms...
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Background The coronavirus disease 2019 (COVID-19) pandemic and related countermeasures hinder health care access and affect mental wellbeing of non-COVID-19 patients. There is lack of evidence on distress and mental health of patients hospitalized due to other reasons than COVID-19—a vulnerable population group in two ways: First, given their risk...
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Irritable bowel syndrome (IBS) results from disordered brain–gut interactions. Identifying susceptibility genes could highlight the underlying pathophysiological mechanisms. We designed a digestive health questionnaire for UK Biobank and combined identified cases with IBS with independent cohorts. We conducted a genome-wide association study with 5...
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Background Irritable bowel syndrome (IBS) appears to have a bidirectional interaction with both depressive and anxiety-related complaints. However, it remains unclear how exactly the psychological complaints, at the individual level, are related to somatic symptoms on a daily basis. This single case study investigates how somatic and psychological...
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Aims : Is there evidence for increased psychological distress and alterations in personality functioning in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to healthy controls (HCs)? Background : In patients with CD and UC, perceived stress is closely associated with changes in disease activity. The stress response is influe...
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Irritable bowel syndrome (IBS) is a gut‐brain disorder in which symptoms are shaped by serotonin acting centrally and peripherally. The serotonin transporter gene SLC6A4 has been implicated in IBS pathophysiology, but the underlying genetic mechanisms remain unclear. We sequenced the alternative P2 promoter driving intestinal SLC6A4 expression and...
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Objective: Deficits in affective processing are associated with impairments in both mental and physical health. The role of affective processing in patients with functional somatic complaints such as irritable bowel syndrome (IBS) remains unclear. Most studies have focused on the capacity for emotional awareness and expression, but neglect other di...
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Background and goal: The current diagnostic concept of somatic symptom disorder (SSD) aims to capture psychological burden due to bodily complaints independent of the medical cause. The aim of this study was to compare patients with chronic gastrointestinal (GI) complaints with SSD (SSD+) and without SSD (SSD-) along sociodemographic, clinical, an...
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Objectives: Overlaps between different functional gastrointestinal disorders (FGIDs) are common. However, little is known about the impact of this overlap on patients' health status. This study is aimed at analyzing the differences between patients with multiple as compared to one single FGID. Methods: A retrospective, cross-sectional study was...
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Background: Approximately 10% of the general population and around one third of adult patients in clinical populations suffer from functional somatic symptoms. These take many forms, are often chronic, impair everyday functioning as well as quality of life, and are cost intensive. Methods: The guideline group (32 medical and psychological profes...
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Background: Persistent somatic symptoms are associated with psychological distress, impaired function, and medical help-seeking behavior. The Patient Health Questionnaire (PHQ)-15 is used as a screening instrument for somatization and as a monitoring instrument for somatic symptom severity. A bifactorial model has been described, with one general f...
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Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental h...
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Background To evaluate the relationship between quality of life (QOL) and physical as well as psychological variables in Chinese breast cancer patients. Methods This multicenter cross-sectional study enrolled 254 Chinese breast cancer patients in different stages and treatment phases. They answered standard instruments assessing QOL (EORTC), somati...
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Background: The aim of this study was to test the operationalization of DSM-5 somatic symptom disorder (SSD) psychological criteria among Chinese general hospital outpatients. Methods: This multicenter, cross-sectional study enrolled 491 patients from 10 general hospital outpatient departments. The structured clinical "interview about cognitive,...
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Background: Our study aimed (1) to describe the proportion of psychological distress among Chinese outpatients at general hospitals, (2) to compare cognitive and behavioral characteristics of patients with different distress patterns, and (3) to investigate the discriminant function of the analyzed variables in indicating the affinity towards the...
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Aim The aim of this study was to calculate disorder-specific excess costs in patients with functional somatic syndromes (FSS). Methods We compared 6-month direct and indirect costs in a patient group with FSS (n = 273) to a control group of the general adult population in Germany without FSS (n = 2914). Data on the patient group were collected bet...
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To formulate therapy goals, we aimed to define the relationship between fecal calprotectin and health-related quality of life in inflammatory bowel diseases (IBDs). This retrospective single-center cross-sectional study included ambulatory IBD patients who had completed standardized questionnaires comprising items of health-related quality of life...
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Die Konversionssyndrome sollten mehr Aufmerksamkeit finden. Sie erfordern ein interdisziplinäres Herangehen zur weiteren Verbesserung des biopsychosozialen Störungsverständnisses. Es gilt, die psychobiologischen Mechanismen der Symptomentstehung und -aufrechterhaltung noch genauer aufzuklären. Die Behandlung sollte einem kooperativen Versorgungsmod...
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Background. The efficacy and safety of opioid therapy in chronic low back pain (CLBP) is under debate. We updated a recent systematic review on the efficacy and safety of opioids in CLBP. Methods. We screened MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) up until October 2013, as well as reference sections of orig...
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Hintergrund Die Wirksamkeit und Sicherheit der Opioidtherapie bei chronischen neuropathischen Schmerzen (CNS) ist umstritten. In der vorliegenden Publikation wird ein kürzlich erschienenes systematisches Cochrane-Review zur Wirksamkeit, Verträglichkeit und Sicherheit von Opioiden bei CNS aktualisiert. Methoden Bis Oktober 2013 wurden MEDLINE, Sc...
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Hintergrund Die Wirksamkeit, Verträglichkeit und Sicherheit der Opioidtherapie bei chronischem Arthroseschmerz ist umstritten. In der vorliegenden Publikation wird ein systematisches Cochrane-Review zur Wirksamkeit und Sicherheit von Opioiden bei chronischem Arthroseschmerz aus dem Jahr 2008 aktualisiert. Methoden Bis Oktober 2013 wurden MEDLINE...
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The sense of coherence (SOC) may explain why some people become ill under stress whereas others remain healthy. SOC is strongly related to perceived health, particularly mental health. Little is known about the physical and mental health statuses associated with SOC among general hospital outpatients in China. This multicentre cross-sectional study...
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In the S3 guidelines on non-specific, functional and somatoform bodily complaints, a broad group of medical and psychological societies as well as patient representatives have for the first time achieved an evidence-based consensus on terminology and care of these patients. This paper summarizes the main background information and recommendations f...
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The patient-doctor relationship (PDR) as perceived by the patient is an important concept in primary care and psychotherapy. The PDR Questionnaire (PDRQ-9) provides a brief measure of the therapeutic aspects of the PDR in primary care. We assessed the internal and external validity of the German version of the PDRQ-9 in a representative cross-secti...
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In primary and secondary medicine "non-specific, functional, and somatoform bodily complaints" are common and often take a chronic course, with the patients' quality of life usually markedly impaired, and give rise to high direct and indirect costs. They are challenging as they can deteriorate in case of inappropriate behavior on the physician's pa...
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Mit der S3-Leitlinie ,,Nicht-spezifische, funktionelle und somatoforme Körperbeschwerden“ wurde erstmals über psychosoziale und somatische Disziplinen hinweg ein breiter, evidenzbasierter Konsens zu Terminologie und Versorgung erreicht. Dieser Beitrag fasst die für Psychotherapeuten wesentlichen Hintergrundinformationen und Empfehlungen zusammen. B...
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Establishing a trustful therapeutic relationship and reflecting on attitudes and behavior is essential in caring for patients with functional pain syndromes. Hope-disappointment circles are common and can be intensified by unfavorable caregiver behavior. A biopsychosocial, empathetic and coping-oriented attitude has proved to be useful. A motivatin...
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Die therapeutische Beziehung stellt die Basis der Behandlung von Patienten mit funktionellen Schmerzsyndromen dar. Ungünstiges Behandlerverhalten kann die typischen Hoffnungs-Enttäuschungs-Zirkel verstärken. Die Reflexion eigener Haltungen und Verhaltensweisen erleichtert den Aufbau einer vertrauensvollen therapeutischen Beziehung. Bewährt hat sich...
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Establishing a trustful therapeutic relationship and reflecting on attitudes and behavior is essential in caring for patients with functional pain syndromes. Hope-disappointment circles are common and can be intensified by unfavorable caregiver behavior. A biopsychosocial, empathetic and coping-oriented attitude has proved to be useful. A motivatin...
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Objective: 4–10% of the general population and 20% of primary care patients suffer from non-specific, functional and somatoform bodily complaints, which are responsible for high health system expenditures. Moreover vulnerability to iatrogenic effects is a common risk to these conditions. A new German guideline was developed to address these clinica...
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In western countries, negative illness perceptions are associated with poor health status and affect health outcomes in primary care populations. The aim of this study is to examine the relationship between illness perception and mental and physical health status in general hospital outpatients in China. This multicentre, cross-sectional study anal...
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Fibromyalgia syndrome as a psychosomatic disorder – Diagnosis and therapy according to current evidence-based guidelines Objectives: The classification and therapy of patients with chronic widespread pain without evidence of somatic factors as an explanation is currently a matter of debate. The diagnostic label “fibromyalgia syndrome”(FMS) has been...
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Somatisch nicht hinreichend erklärte Körperbeschwerden sind der Anlass für rund 20% aller Arztbesuche. Je nach Schwere des Verlaufs und je nach fachlichem Hintergrund des Behandlers werden sie als "nicht-spezifisch", "funktionell" oder "somatoform" bezeichnet. Diese Parallelklassifikation birgt die Gefahr einer "Scheuklappendiagnostik", bei der ein...
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Interface problems between health care sectors hinder collaborative care in functional syndromes. The speciAL trial investigated a disorder-oriented group intervention conducted by the general practitioner (GP) and a psychosomatic specialist (PS) in the GP's office. To evaluate the GP-PS cooperation, our qualitative study analysed free text stateme...
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chotherapie (DGPM). Eine wichtige Ergänzung zu dieser syndrom-und fächerübergreifenden Leit-linie stellt die von der Deutschen Gesellschaft für Psychologie (DGPs), Fachgruppe Klinische Psy-chologie und Psychotherapie, initiierte und koor-dinierte "Evidenzbasierte Leitlinie zur Psycho-therapie somatoformer Störungen und asso-ziierter Syndrome" dar [...
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BACKGROUND: The EQ-5D is a generic questionnaire providing a preference-based index score applicable to cost-utility analysis. This is the first study to validate the EQ-5D in patients with somatoform disorders. METHODS: Data of the EQ-5D descriptive system, the British and the German EQ-5D index and the EQ Visual Analogue Scale, the Patient Health...
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The S3 guideline "Dealing with patients with non-specific, functional and somatoform bodily symptoms" emphasizes the similarities in the management of the manifold manifestations of so called "medically unexplained symptoms" and gives recommendations for a stepped and collaborative diagnostic and therapeutic approach in all subspecialties and all l...
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OBJECTIVES: The classification and therapy of patients with chronic widespread pain without evidence of somatic factors as an explanation is currently a matter of debate. The diagnostic label "fibromyalgia syndrome"(FMS) has been rejected by some representatives of general and psychosomatic medicine. METHODS: A summary is given of the main recomme...
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Background: Patients with medically unexplained symptoms (MUS) are frequent in primary care and substantially impaired in their quality of life (QoL). Specific training of general practitioners (GPs) alone did not demonstrate sustained improvement at later follow-up in current reviews. We evaluated a collaborative group intervention. Methods: We...
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The illness behavior of patients with medically unexplained physical symptoms (MUS) depends largely on what the patient believes to be the cause of the symptoms. Little data are available on the illness attributions of patients with MUS in China. This cross-sectional study investigated the illness attributions of 96 patients with MUS in the outpati...
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4-10% of the general population and 20% of primary care patients have what are called "non-specific, functional, and somatoform bodily complaints." These often take a chronic course, markedly impair the sufferers' quality of life, and give rise to high costs. They can be made worse by inappropriate behavior on the physician's part. The new S3 guide...