Abstract
Background: At the Clinical Centre of Excellence for Body, Mind and Health, integrated care models are used to provide treatment to patients with Somatic Symptom and Related Disorders (SSD). The aim of this study is to describe complexity of SSD patients using the INTERMED. This instrument has been developed for patients with chronic medical conditions. So far, it has not been used in a population with medically (un-)explained symptoms. Method: The INTERMED indicates case complexity according to the biopsychosocial model of health. It was used to measure case complexity in outpatients with SSD. In this cross-sectional study, data was collected retrospectively from patient files. A quantitative description of complexity will be provided with descriptive statistics and Pearson correlations of complexity scores and demographic variables. Results: Of the total sample (N = 262), 37.7% was male, mean (SD) age was 41.7 (13.2), with an average educational level. The mean INTERMED score was 24.1, indicating high overall complexity in this SSD population. More specifically, 72.6% of the scores indicated complexity to high complexity. The total score correlated significantly with high age (r = .20). Conclusion: The current study demonstrated that SSD patients are complex on multiple levels, indicating the need of individual case management and multi-disciplinary involvement. Compared to other studies, SSD patients were more complex compared to patients with rheumatoid arthritis (Mean < 20), complex regional pain syndrome (Mean = 19) and liver pre-transplant patients (Mean = 20). Patients with a combination of substance abuse, a medical condition and psychiatric illness were more complex than our SSD sample (Mean = 37). The results indicate that patients with SSD in a centre of excellence are highly complex. The INTERMED provides a comprehensive overview of patient functioning and can be used in clinical practice to investigate patient complexity. Further research should focus on its clinical use in psychiatric settings, its implementation, and its use in long-term monitoring of patient outcomes. Early examination of case complexity will contribute to improved case management, treatment selection, and multidisciplinary involvement. The current study emphasizes the need for integrated patient care for SSD patients, exceeding normal medical and psychiatric procedures.
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