Oyama Oliver, Paltoo Catherine, Greengold Julian
Family Medicine Residency Program, Morton Plant Mease/University of South Florida, Clearwater, Florida 33755, USA.
Am Fam Physician. 2007 Nov 1;76(9):1333-8.
The somatoform disorders are a group of psychiatric disorders that cause unexplained physical symptoms. They include somatization disorder (involving multisystem physical symptoms), undifferentiated somatoform disorder (fewer symptoms than somatization disorder), conversion disorder (voluntary motor or sensory function symptoms), pain disorder (pain with strong psychological involvement), hypochondriasis (fear of having a life-threatening illness or condition), body dysmorphic disorder (preoccupation with a real or imagined physical defect), and somatoform disorder not otherwise specified (used when criteria are not dearly met for one of the other somatoform disorders). These disorders should be considered early in the evaluation of patients with unexplained symptoms to prevent unnecessary interventions and testing. Treatment success can be enhanced by discussing the possibility of a somatoform disorder with the patient early in the evaluation process, limiting unnecessary diagnostic and medical treatments, focusing on the management of the disorder rather than its cure, using appropriate medications and psychotherapy for comorbidities, maintaining a psychoeducational and collaborative relationship with patients, and referring patients to mental health professionals when appropriate.
躯体形式障碍是一组导致无法解释的身体症状的精神障碍。它们包括躯体化障碍（涉及多系统身体症状）、未分化躯体形式障碍（症状比躯体化障碍少）、转换障碍（随意运动或感觉功能症状）、疼痛障碍（有强烈心理因素参与的疼痛）、疑病症（害怕患有危及生命的疾病或状况）、躯体变形障碍（过度关注真实或想象中的身体缺陷）以及未另行说明的躯体形式障碍（用于不符合其他躯体形式障碍标准的情况）。在评估有无法解释症状的患者时，应尽早考虑这些障碍，以避免不必要的干预和检查。通过在评估过程早期与患者讨论躯体形式障碍的可能性、限制不必要的诊断和医学治疗、关注障碍的管理而非治愈、针对共病使用适当的药物和心理治疗、与患者保持心理教育和协作关系以及在适当的时候将患者转介给心理健康专业人员，可以提高治疗成功率。
