Kirmayer L J, Robbins J M
Department of Psychiatry, McGill University, Montreal, Canada.
J Nerv Ment Dis. 1991 Nov;179(11):647-55. doi: 10.1097/00005053-199111000-00001.
Three definitions of somatization were operationalized: (a) high levels of functional somatic distress, measured by the Somatic Symptom Index (SSI) of the Diagnostic Interview Schedule; (b) hypochondriasis measured by high scores on a measure of illness worry in the absence of evidence for serious illness; and (c) exclusively somatic clinical presentations among patients with current major depression or anxiety. Of 685 patients attending two family medicine clinics, 26.3% met criteria for one or more forms of somatization. While DSM-III somatization disorder had a prevalence of only 1% in this population, 16.6% of the patients met abridged criteria for subsyndromal somatization disorder (SSI 4,6). Hypochondriacal worry had a prevalence of 7.7% in the clinic sample. Somatized presentations of current major depression or anxiety disorder had a prevalence of 8%. The three forms of somatization were associated with different sociodemographic and illness behavior characteristics. A majority of patients met criteria for only one type of somatization, suggesting that distinct pathogenic processes may be involved in each of the three types.
(a) 高水平的功能性躯体困扰，通过诊断性访谈表的躯体症状指数（SSI）来衡量；(b) 在没有严重疾病证据的情况下，通过对疾病担忧程度的高分测量来衡量疑病症；(c) 当前患有重度抑郁症或焦虑症的患者中仅表现为躯体症状。在两家家庭医学诊所就诊的685名患者中，26.3%符合一种或多种躯体化形式的标准。虽然在该人群中，DSM-III躯体化障碍的患病率仅为1%，但16.6%的患者符合亚综合征性躯体化障碍的简化标准（SSI 4,6）。在诊所样本中，疑病性担忧的患病率为7.7%。当前重度抑郁症或焦虑症的躯体化表现患病率为8%。这三种躯体化形式与不同的社会人口学和疾病行为特征相关。大多数患者仅符合一种躯体化类型的标准，这表明这三种类型可能涉及不同的致病过程。
