Miller Robert C
Assistant Professor, Neuropsychiatry and Behavioral Sciences Edward Via Virginia College of Osteopathic Medicine 2265 Kraft Drive Blacksburg, Virginia, 24060, USA.
Osteopath Med Prim Care. 2008 Apr 29;2:6. doi: 10.1186/1750-4732-2-6.
Individuals with somatic preoccupation constitute a substantial number of primary care patients. Somatically preoccupied patients are challenging to primary care physicians for several reasons including patient complaints consuming a great deal of physician time, expense to diagnose and treat and strain on the physician-patient relationship. This paper examines and discusses how disruptions in early attachment relationships such as often occurs when a female is a victim of child sexual abuse may result in somatic preoccupation in adulthood.
Attachment theory provides a useful framework for primary care physicians to conceptualize somatic preoccupation. Utilization and containment techniques grounded in an understanding of attachment dynamics aid the physician in developing a sound physician-patient relationship. Successfully engaging the patient in treatment prevents misunderstandings that frequently derail medical care for somatically preoccupied patients.
患有躯体先占观念的个体在初级保健患者中占相当比例。躯体先占观念患者给初级保健医生带来了诸多挑战，原因包括患者的诉求耗费医生大量时间、诊断和治疗费用高昂以及医患关系紧张。本文探讨并讨论早期依恋关系的中断（比如女性遭受儿童性虐待时经常发生的情况）如何可能导致成年后的躯体先占观念。
依恋理论为初级保健医生理解躯体先占观念提供了一个有用的框架。基于对依恋动态的理解的运用和容纳技巧有助于医生建立良好的医患关系。成功使患者参与治疗可防止经常使躯体先占观念患者的医疗护理脱轨的误解。
