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精神样障碍:躯体形式障碍的精神学类似情况。

Psychiatriform disorders: psychiatric analogues of somatoform disorders.

作者信息

Mullen Richard, Menkes David B

机构信息

Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.

出版信息

Int J Soc Psychiatry. 2008 Sep;54(5):395-401. doi: 10.1177/0020764008090423.

Abstract

BACKGROUND

Somatoform disorders can be understood to mimic supposedly more 'legitimate' physical disorders. To the extent that mental disorders are now also often considered legitimate, might clinicians expect to encounter the psychiatric equivalent of somatoform disorders, 'psychiatriform disorders'?

METHOD

The relevant literature on somatoform disorders is reviewed in light of the tendency for mental and physical symptoms to co-occur.

DISCUSSION

Illness attribution and behaviour may explain some of the recent rise in the prevalence of mental disorder. Hypotheses regarding the cause and nature of somatoform disorders are applied to their proposed psychiatric equivalent. Despite lack of current recognition, there is a strong theoretical basis for the existence of psychiatriform disorders. Psychiatriform disorders can be expected to have similar causes, comorbidity, and response to treatment, as somatoform disorders. A variety of cultural forces may be contributing to a rise in prevalence.

CONCLUSION

As with somatoform disorders, psychiatriform disorders present problems in their distinction from conscious fabrication and from the ;legitimate' disorders they mimic. Given their likely prevalence and associated impairments, psychiatriform disorders warrant further examination, despite the methodological difficulties this presents.

摘要

背景

躯体形式障碍可被理解为模仿所谓更“典型”的躯体疾病。鉴于现在精神障碍也常常被视为典型病症,临床医生是否可能会遇到躯体形式障碍的精神科对应物,即“精神科形式障碍”呢?

方法

鉴于精神症状和躯体症状常常同时出现的趋势,对有关躯体形式障碍的相关文献进行了综述。

讨论

疾病归因和行为可能解释了近期精神障碍患病率上升的部分原因。关于躯体形式障碍病因和本质的假设被应用于其假定的精神科对应物。尽管目前未得到认可,但精神科形式障碍的存在有坚实的理论基础。精神科形式障碍预计与躯体形式障碍有相似的病因、共病情况及治疗反应。多种文化因素可能促使患病率上升。

结论

与躯体形式障碍一样,精神科形式障碍在与有意识编造以及与它们所模仿的“典型”疾病相区分方面存在问题。鉴于其可能的患病率及相关损害,尽管存在方法上的困难,精神科形式障碍仍值得进一步研究。

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