Hessel Aike, Geyer Michael, Schumacher Jörg, Brähler Elmar
Universität Leipzig, Klinik und Poliklinik für Psychotherapie und Psychosomatische Medizin, K.-Tauchnitz-Str. 25, D-04107 Leipzig, Germany.
Z Psychosom Med Psychother. 2002;48(1):38-58. doi: 10.13109/zptm.2002.48.1.38.
The study presents the subjective responses of a representative sample of the German population (2050 subjects, aged 14 to 92 years) on the prevalence of somatoform complaints, using the SOMS (Screening for somatoform disorders) developed by Rief et al. (1997). The results show that somatoform disorders are widespread in the German population. The symptoms named most frequently were pains in the back, aching limbs, pains in the arms or legs, headaches, facial pains and sensations of fullness in the stomach. Women named more somatoform complaints than men and elderly suffered more than the young. The higher rate found in East Germany could be accounted for by the responses of the East German women. Of particular economic and political relevance is the health care utilization behaviour of this group of patients. High medical consultation frequencies and increasing drug consumption were found for a significant proportion of all patients with somatoform disorders. In apparent contradiction to these findings is the classification according to DSM-IV and ICD-10, which diagnose somatoform disorders in only 0.2%-0.4% of the population. Such low prevalence can be attributed to the restrictive diagnostic criteria applied by these systems which obscure the real frequency of somatoform syndromes requiring specific treatment.
该研究呈现了德国代表性人群样本（2050名受试者，年龄在14至92岁之间）对躯体形式主诉患病率的主观反应，采用了里夫等人（1997年）开发的SOMS（躯体形式障碍筛查量表）。结果表明，躯体形式障碍在德国人群中广泛存在。提及频率最高的症状是背痛、四肢酸痛、手臂或腿部疼痛、头痛、面部疼痛以及胃部饱胀感。女性提及的躯体形式主诉比男性多，老年人比年轻人更多。东德地区较高的患病率可能是由东德女性的反应造成的。该组患者的医疗保健利用行为具有特别的经济和政治相关性。在所有患有躯体形式障碍的患者中，相当大比例的人医疗咨询频率高且药物消费量不断增加。与这些发现明显矛盾的是，根据《精神疾病诊断与统计手册》第四版（DSM-IV）和《国际疾病分类》第十版（ICD-10）的分类，在人群中仅0.2%-0.4%的人被诊断为躯体形式障碍。如此低的患病率可归因于这些系统所采用的限制性诊断标准，这些标准掩盖了需要特定治疗的躯体形式综合征的实际发生率。
