Geist Rose, Weinstein Michael, Walker Lynn, Campo John V
Departments of Psychiatry and Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario.
Paediatr Child Health. 2008 Jul;13(6):487-91.
Medically unexplained symptoms in young people can present a challenge for primary care physicians to manage. Despite the prevalence of this clinical problem, physicians feel ill-equipped to deal with it. Families may attribute symptoms to an organic cause, despite the absence of identified pathology, and often resist considering psychosocial contributing factors. The present article outlines the key principles in the management of medically unexplained symptoms. Treatment focuses on building a therapeutic alliance with the patient and the family, the use of psychotherapeutic interventions and the role of psychopharmacology. A family-oriented rehabilitative approach to care, with a focus on functional improvement rather than symptom reduction, is emphasized.
年轻人中医学上无法解释的症状给初级保健医生的管理带来了挑战。尽管这一临床问题普遍存在,但医生们觉得应对起来能力不足。尽管未发现病理状况,家属可能将症状归因于器质性病因,并且常常抗拒考虑心理社会方面的促成因素。本文概述了医学上无法解释的症状的管理关键原则。治疗重点在于与患者及其家属建立治疗联盟、运用心理治疗干预措施以及心理药理学的作用。强调采用以家庭为导向的康复护理方法,重点是功能改善而非症状减轻。