Ballas Christos A, Staab Jeffrey P
Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
CNS Spectr. 2003 Dec;8(12 Suppl 3):20-6. doi: 10.1017/s1092852900008245.
The treatment of patients with unexplained medical symptoms is difficult because there is neither a clear etiology for the symptoms, nor a useful paradigm with which to understand and treat them. Patients with such symptoms are often referred to psychiatry with vague diagnoses of "somatization" or "hypochondriasis." Rather than considering somatoform diagnoses based on the number or diversity of physical symptoms, evolving research suggests an emphasis on the type of physical symptom as an indicator of Axis I pathology. This article links specific symptomatic complaints, such as chronic pain, chest pain, and dizziness, to the respective Axis I disorders associated with them, such as depression, panic disorder, and anxiety disorders.
对有不明医学症状的患者进行治疗很困难，因为这些症状既没有明确的病因，也没有一个有用的范例来理解和治疗它们。有此类症状的患者常常被转诊至精神科，被含糊地诊断为“躯体化”或“疑病症”。越来越多的研究表明，不应基于躯体症状的数量或多样性来考虑躯体形式诊断，而应强调将躯体症状的类型作为轴I病理的一个指标。本文将慢性疼痛、胸痛和头晕等特定症状性主诉与与之相关的各自轴I障碍（如抑郁症、惊恐障碍和焦虑症）联系起来。
