Burton Christopher
Sanquhar Health Centre, Station Road, Sanquhar, Dumfries-shire DG4 6BT.
Br J Gen Pract. 2003 Mar;53(488):231-9.
Patients commonly present in primary care with symptoms for which no physical pathology can be found. This study is a review of published research on medically unexplained symptoms (MUPS) in primary care. A literature review and qualitative comparison of information was carried out. Four questions were addressed: what is the prevalence of MUPS; to what extent do MUPS overlap with psychiatric disorder; which psychological processes are important in patients with MUPS; and what interventions are beneficial? Neither somatised mental distress nor somatisation disorders, based on symptom counts, adequately account for most patients seen with MUPS. There is substantial overlap between different symptoms and syndromes, suggesting they have much in common. Patients with MUPS may best be viewed as having complex adaptive systems in which cognitive and physiological processes interact with each other and with their environment. Cognitive behavioural therapy and antidepressant drugs are both effective treatments, but their effects may be greatest when the patient feels empowered by their doctor to tackle their problem.
患者在初级保健中常表现出一些无法找到身体病理学依据的症状。本研究是对已发表的关于初级保健中医学无法解释症状（MUPS）的研究进行的综述。开展了文献综述和信息的定性比较。探讨了四个问题：MUPS的患病率是多少；MUPS与精神障碍的重叠程度如何；哪些心理过程对MUPS患者很重要；以及哪些干预措施是有益的？基于症状计数的躯体化精神困扰和躯体化障碍都不能充分解释大多数患有MUPS的患者情况。不同症状和综合征之间存在大量重叠，表明它们有很多共同之处。患有MUPS的患者最好被视为具有复杂适应系统，其中认知和生理过程相互作用并与他们的环境相互作用。认知行为疗法和抗抑郁药物都是有效的治疗方法，但当患者感到医生赋予他们解决问题的能力时，其效果可能最为显著。
