Schuepbach W M Michael, Adler Rolf H, Sabbioni Marzio E E
Medical Division C.L. Lory-Haus, Inselspital, University of Berne, Switzerland.
Psychother Psychosom. 2002 Jan-Feb;71(1):11-7. doi: 10.1159/000049339.
The range of unnoticed physical disorders in patients diagnosed with a psychogenic disorder varies widely. We investigated the accuracy of the clinical diagnosis of 'psychogenic disorder' where physical symptoms suggesting a somatic condition (PDPS) are present.
All 162 cases of PDPS diagnosed between 01.01.1986 and 31.12.1987 in a medical clinic specializing in psychosomatic medicine were reviewed after 5 years. 148 follow-ups were complete. Initial diagnoses had been established using positive criteria for psychogenic diagnosis in a semistructured interview and a comprehensive clinical workup by trained clinicians.
In 2 (1.35%) foreign-language patients of 148 an orthopedic diagnosis had been missed. In 6 patients, the family physician gave formerly known findings a different interpretation. Half of these patients were foreigners; 5 were men; none improved; 5 had back pain.
A semistructured interview and positive criteria for psychogenic diagnosis permitted high diagnostic accuracy with an error of 1.35% in 148 cases.
被诊断为精神性疾病的患者中未被察觉的身体疾病范围差异很大。我们调查了存在提示躯体疾病的身体症状（PDPS）时“精神性疾病”临床诊断的准确性。
对1986年1月1日至1987年12月31日在一家身心医学专科诊所诊断的所有162例PDPS病例在5年后进行了回顾。148例随访完整。初始诊断是通过在半结构化访谈中使用精神性诊断的阳性标准以及由训练有素的临床医生进行全面的临床检查来确定的。
在148例患者中有2例（1.35%）外国患者漏诊了骨科疾病。在6例患者中，家庭医生对先前已知的检查结果给出了不同的解释。这些患者中有一半是外国人；5例为男性；无一例病情好转；5例有背痛。
半结构化访谈和精神性诊断的阳性标准在148例病例中允许较高的诊断准确性，错误率为1.35%。
