Bouvet de La Maisonneuve O
CCA, Service Hospitalo-Universitaire de Santé Mentale et de Thérapeutique, Centre Hospitalier Sainte-Anne, Paris.
Encephale. 1991 Dec;17 Spec No 3:427-9.
Somatic complaints are core symptoms of depressive illness. Although none can be said to be specific, some combinations appear typical of depression. In the field of somatic complaints, depression constitutes a factor of good prognosis because of a positive response to antidepressants. On the other hand, in the field of depression, somatic complaints constitute a factor of poor prognosis and of resistance to treatment. Peripherally to depression, the clinical picture of anxiety, somatoform disorders and hypochondriasis contains somatic complaints. Anxiety is less refractory to treatment than somatoform disorders and somatoform disorders less than hypochondriasis. Antidepressants are a major treatment in those cases. No study could identify a mechanism of action but dopaminergic antidepressants could be particularly interesting. Ohayon and Caulet reported the efficacy of amoxapine in a population of 134 patients with somatic complaints and diagnoses of depression, anxiety or somatoform disorders.
躯体主诉是抑郁症的核心症状。虽然没有一种主诉可说是具有特异性的,但某些组合似乎是抑郁症的典型表现。在躯体主诉领域,由于对抗抑郁药有阳性反应,抑郁症构成预后良好的一个因素。另一方面,在抑郁症领域,躯体主诉构成预后不良和治疗抵抗的一个因素。在抑郁症之外,焦虑症、躯体形式障碍和疑病症的临床表现也包含躯体主诉。焦虑症的治疗难治性低于躯体形式障碍,而躯体形式障碍的难治性又低于疑病症。抗抑郁药是这些病例的主要治疗药物。尚无研究能够确定其作用机制,但多巴胺能抗抑郁药可能特别值得关注。奥哈扬和考莱特报告了阿莫沙平在134例有躯体主诉且被诊断为抑郁症、焦虑症或躯体形式障碍的患者群体中的疗效。