Hsi Y Y, Lee M B, Chen C Y, Lee S D, Liu H L, Lee Y T
Department of Family Medicine, College of Medicine, National Taiwan University, Taipei, R.O.C.
J Formos Med Assoc. 1990 Jul;89(7):606-12, 604.
The aim of this study was to explore the association between psychosocial variables and somatic complaints in terms of the biopsychosocial model. The analysis showed that both socioeconomic and psychological variables play a prominent role in the subjective complaints of coronary symptoms as follows: (1) Functional class: A low occupational index was found to be a predictor of much disability. Subjects with higher self-ratings of psychiatric symptoms (i.e. phobia, depression, interpersonal hypersensitivity), lower personal well-being (i.e. esteem, competence), and major social maladaptation had significantly more disability. (2) Chest pain: Patients with a higher morbidity of chest pain were more likely to be female, have less education, have more social maladjustment, and have less social support. Higher scores of psychiatric symptoms (i.e. anxiety, depression, hostility) and a perception of threatening by others were highly correlated with the severity of chest discomfort. Physicians should be aware of the ways in which psychosocial and biomedical variables may interact at many levels, especially for the patients with unexplained physical symptoms or social dysfunction.
本研究旨在从生物心理社会模型的角度探讨心理社会变量与躯体主诉之间的关联。分析表明,社会经济和心理变量在冠心病症状的主观主诉中均发挥着重要作用,具体如下:(1)功能分级:低职业指数被发现是严重残疾的一个预测因素。精神症状自评较高(即恐惧症、抑郁症、人际过敏症)、个人幸福感较低(即自尊、能力)以及存在严重社会适应不良的受试者残疾程度明显更高。(2)胸痛:胸痛发病率较高的患者更可能为女性、受教育程度较低、社会适应不良情况更多且社会支持更少。精神症状得分较高(即焦虑、抑郁、敌意)以及他人威胁感与胸部不适的严重程度高度相关。医生应意识到心理社会和生物医学变量在多个层面可能相互作用的方式,尤其是对于有不明身体症状或社会功能障碍的患者。