Sheehan B, Bass C, Briggs R, Jacoby R
Department of Psychiatry, University of Oxford.
Psychol Med. 2003 Jul;33(5):867-77. doi: 10.1017/s003329170300789x.
The importance of somatization among older primary care attenders is unclear. We aimed to establish the prevalence, persistence and associations of somatization among older primary care attenders, and the associations of frequent attendance.
One hundred and forty primary care attenders over 65 years were rated twice, 10 months apart, on measures of somatization, psychiatric status, physical health and attendance.
The syndrome of GMS hypochondriacal neurosis had a prevalence of 5% but was transient. Somatized symptoms and attributions were persistent and associated with depression, physical illness and perceived poor social support. Frequent attenders (top third) had higher rates of depression, physical illness and somatic symptoms, and lower perceived support.
Somatization is common among older primary care attenders and has similar correlates to younger primary care somatizers. Psychological distress among older primary care attenders is associated with frequent attendance. Improved recognition should result in benefits to patients and services.
躯体化在老年初级保健就诊者中的重要性尚不清楚。我们旨在确定老年初级保健就诊者中躯体化的患病率、持续性及相关性，以及频繁就诊的相关性。
对140名65岁以上的初级保健就诊者进行两次评估，间隔10个月，评估内容包括躯体化、精神状态、身体健康状况和就诊情况。
广泛性焦虑障碍疑病性神经症综合征的患病率为5%，但为一过性。躯体化症状和归因具有持续性，并与抑郁、躯体疾病及感知到的社会支持不足相关。频繁就诊者（前1/3）的抑郁、躯体疾病和躯体症状发生率更高，而感知到的支持更低。
躯体化在老年初级保健就诊者中很常见，且与年轻初级保健躯体化者有相似的关联因素。老年初级保健就诊者的心理困扰与频繁就诊有关。提高认知度应会给患者和服务带来益处。
