Facchinetti F, Demyttenaere K, Fioroni L, Neri I, Genazzani A R
Department of Obstetrics and Gynecology, University of Modena, Italy.
Psychother Psychosom. 1992;58(3-4):137-54. doi: 10.1159/000288622.
In this paper current issues on four psychosomatic disorders related to gynecology will be reviewed. The history, nosological problems and psychoneuroendocrine correlates of psychogenic amenorrhea have been summarized taking into account the important role of psychological factors in inducing loss of menses. Definition and diagnostic problems in assessing menstrually related disorders (formerly premenstrual syndrome) have been reviewed, looking at this syndrome as a disorder of adaptation to the cyclical changes of neuroendocrine functions. The impact of stress on fertility and, on the other hand, the effects of infertility on psychological well-being have been pointed out trying to ascertain the pathways involved in these mutual relationships. Finally, the issue of mood changes at menopause and the effects of steroid replacement on affective state have been discussed. As a whole, these evidences indicate the importance of a close cooperation between gynecologist and psychiatrist in the management of gynecological disorders.
本文将综述与妇科相关的四种心身疾病的当前问题。考虑到心理因素在导致月经缺失中的重要作用,总结了心因性闭经的病史、分类学问题及心理神经内分泌相关性。回顾了评估月经相关疾病(原经前综合征)的定义和诊断问题,将该综合征视为一种适应神经内分泌功能周期性变化的障碍。指出了压力对生育的影响,以及另一方面,不孕对心理健康的影响,试图确定这些相互关系中涉及的途径。最后,讨论了更年期情绪变化问题以及类固醇替代对情感状态的影响。总体而言,这些证据表明妇科医生和精神科医生在妇科疾病管理中密切合作的重要性。