Tazaki Miyako, Landlaw Kenneth
Tokyo University of Science, Tokyo, Japan.
Int Rev Psychiatry. 2006 Feb;18(1):67-73. doi: 10.1080/09540260500467046.
Due to the lack of adequate cure or medication for somatoform disorders, cognitive-behavioural intervention or cognitive-behavioural therapy (CBT) seems to be an optimal treatment resource for patients with these disorders, since the cause of the somatoform disorders cannot to be explained by medical illness, but can be analyzed in the process of both responding and operant conditioning. According to the reviews, randomized controlled trials are limited, but the efficacy of the intervention is quite impressive. Most of the studies use multiple treatment strategies, and no standardized treatment methods have been established. In general, the following steps are taken in CBT treatments: (1) assessment; (2) rationale of treatment choice; (3) course of treatment; (4) evaluation of treatment; and (5) reviewing treatment effects. In CBT, functional analysis in the assessment session is the key to success, to identify the relationship among discriminative stimuli and consequences, in order to reduce the undesirable behaviour, and the most effective approach of the treatment would be a combination of multiple techniques. However, as the efficacy of the treatments is established, expansion of accurate knowledge of functional analysis and training sessions for health care providers and patients should be provided. Further research should explore the effect of individual techniques, and comparison should be made to identify the relative benefits of the techniques using both individual, and group format.
由于躯体形式障碍缺乏足够的治愈方法或药物，认知行为干预或认知行为疗法（CBT）似乎是这些疾病患者的最佳治疗资源，因为躯体形式障碍的病因无法用医学疾病来解释，但可以在应答性和操作性条件反射过程中进行分析。根据综述，随机对照试验有限，但干预的效果相当显著。大多数研究使用多种治疗策略，尚未建立标准化的治疗方法。一般来说，CBT治疗采取以下步骤：（1）评估；（2）治疗选择的基本原理；（3）治疗过程；（4）治疗评估；以及（5）审查治疗效果。在CBT中，评估环节的功能分析是成功的关键，以识别辨别性刺激和后果之间的关系，从而减少不良行为，最有效的治疗方法是多种技术的结合。然而，随着治疗效果的确立，应提供关于功能分析的准确知识扩展以及针对医疗保健提供者和患者的培训课程。进一步的研究应探索个体技术的效果，并进行比较以确定使用个体和团体形式的技术的相对益处。
