Nimnuan C, Hotopf M, Wessely S
Academic Department of Psychological Medicine, Guy's King's and St. Thomas' School of Medicine and Institute of Psychiatry, 103 Denmark Hill, De Crespigny Park, London SE5 8AF, UK.
J Psychosom Res. 2001 Jul;51(1):361-7. doi: 10.1016/s0022-3999(01)00223-9.
This study aimed to estimate the prevalence and risk factors for medically unexplained symptoms across a variety of specialities.
A cross-sectional survey was conducted at two general hospitals in southeast London between 1995 and 1997. Eight hundred and ninety consecutive new patients from seven outpatient clinics were included. Demographic and clinical characteristic variables were assessed.
Five hundred eighty-two (65%) of the subjects surveyed returned completed questionnaires. A final diagnosis was available in 550 (62%). Two hundred twenty-eight (52%) fulfilled criteria for medically unexplained symptoms. The highest prevalence was in the gynecology clinic (66%). After adjustment for confounders, medically unexplained symptoms were associated with being female, younger, and currently employed. Psychiatric morbidity per se was not associated with the presence of medically unexplained symptoms, but was more likely in those complaining of multiple symptoms. Those with medically unexplained symptoms were less disabled, but more likely to use alternative treatment in comparison with those whose symptoms were medically explained. Patients with medically unexplained symptoms were more likely to attribute their illness to physical causes as opposed to lifestyle factors.
Medically unexplained symptoms are common across general/internal medicine and represent the most common diagnosis in some specialities. Medical behavior, training, and management need to take this into account.
本研究旨在评估各个专科中不明原因症状的患病率及风险因素。
1995年至1997年间，在伦敦东南部的两家综合医院开展了一项横断面调查。纳入了来自七个门诊科室的890名连续就诊的新患者。对人口统计学和临床特征变量进行了评估。
582名（65%）接受调查的受试者返回了完整问卷。550名（62%）有最终诊断结果。228名（52%）符合不明原因症状的标准。患病率最高的是妇科门诊（66%）。在对混杂因素进行调整后，不明原因症状与女性、年轻以及目前就业有关。精神疾病本身与不明原因症状的存在无关，但在那些主诉多种症状的患者中更常见。与症状能从医学上解释的患者相比，有不明原因症状的患者残疾程度较低，但更有可能使用替代疗法。有不明原因症状的患者更倾向于将其疾病归因于身体原因而非生活方式因素。
不明原因症状在普通内科/内科中很常见，并且在某些专科中是最常见的诊断。医疗行为、培训和管理需要考虑到这一点。
