Kroenke Kurt, Rosmalen Judith G M
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Med Clin North Am. 2006 Jul;90(4):603-26. doi: 10.1016/j.mcna.2006.04.003.
Half of all outpatient encounters are precipitated by physical complaints, of which one third to one half are medically unexplained symptoms, and 20% to 25% are chronic or recurrent. Many of the patients suffer from one or more discrete symptoms, whereas others have functional somatic syndromes. Individual symptoms and somatic syndromes are associated with impaired quality of life, increased health care use, and diminished patient and provider satisfaction. This article provides an overview of (1) unexplained symptoms and somatization; (2) limitations of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition in classifying somatoform disorders; (3) predictors of psychiatric comorbidity in patients who have physical symptoms; and (4) measurement and management of symptoms.
所有门诊就诊中有一半是由身体不适引发的，其中三分之一到二分之一是医学上无法解释的症状，20%到25%是慢性或复发性的。许多患者患有一种或多种离散症状，而其他患者则患有功能性躯体综合征。个体症状和躯体综合征与生活质量受损、医疗保健使用增加以及患者和提供者满意度降低有关。本文概述了：（1）无法解释的症状和躯体化；（2）《精神障碍诊断与统计手册》第四版在对躯体形式障碍进行分类方面的局限性；（3）有身体症状患者精神共病的预测因素；以及（4）症状的测量和管理。
