Ohayon M, Caulet M, Bosc M
Département de psychiatrie, Université de Montréal, Québec.
Can J Psychiatry. 1992 May;37(4):213-20. doi: 10.1177/070674379203700401.
Somatic complaints are very common in general medical practice. They are not identified as psychic disorders and are treated symptomatically. We explore two kind of problems: 1. methodological problems such as the instruments to use to examine somatic complaints (it is evident that a checklist does not give the best results with suggestible patients); and 2. the relationships between somatic complaints and psychic disorders such as anxiety, depression and somatoform disorders. Psychiatric nosology is by no means clear and includes many diagnoses from "hysteria" to "hypochondria" or "psychosomatic", "somatization". In this study, we compare the symptoms collected by general practitioners, and their clinical diagnoses to those obtained by an automatic DSM-III diagnostic program. Adinfer was modified so that three DSM decision trees were systematically scanned: depressive, anxiety and somatoform disorders. This allows for an epidemiological study of somatic complaints and their relationship to depression and anxiety. The subjects' score on rating scales for anxiety and depression are compared with the diagnoses made by the expert system. We discuss the significance of somatic symptoms, the DSM classes and the value of expert systems in epidemiological studies.
躯体主诉在普通医疗实践中非常常见。它们未被认定为精神障碍，而是进行对症治疗。我们探讨两类问题：1. 方法学问题，例如用于检查躯体主诉的工具（显然，对于易受暗示的患者，检查表无法得出最佳结果）；2. 躯体主诉与精神障碍如焦虑、抑郁和躯体形式障碍之间的关系。精神病学分类法远非清晰明确，涵盖了从“癔症”到“疑病症”或“心身疾病”“躯体化”等多种诊断。在本研究中，我们将全科医生收集的症状及其临床诊断与通过自动DSM - III诊断程序获得的结果进行比较。对Adinfer进行了修改，以便系统地扫描三个DSM决策树：抑郁、焦虑和躯体形式障碍。这使得能够对躯体主诉及其与抑郁和焦虑的关系进行流行病学研究。将受试者在焦虑和抑郁评定量表上的得分与专家系统做出的诊断进行比较。我们讨论躯体症状的意义、DSM分类以及专家系统在流行病学研究中的价值。
