Groeneweg C E, Sidler D, Vasella D L, Adler R H
Medizinische Abteilung Lory-Haus, Inselspital, Bern.
Schweiz Rundsch Med Prax. 1991 May 7;80(19):529-36.
The fear to miss the diagnosis of somatic processes in "functional" disorders and the ignorance of the positive criteria for the diagnosis of conversion (physical expression of conflicts) and of psychophysiological disorder (somatic symptoms and signs, accompanying affectivity) lead to diagnosing by exclusion of somatic disorders. Its consequences are extensive, damaging procedures and a postponement of a diagnosis which integrates somatic, psychic and social components by seven to eight years. Based on positive criteria, which had been collected by means of a bio-psycho-social approach to the patient, ten were diagnosed as suffering from conversion and 22 from psychophysiological disorders. Five years later the patients were reassessed. In none of the cases a somatic diagnosis emerged, which would have been responsible for the initial complaints five years earlier. The diagnoses "conversion" and "psychophysiological disorder" proved to be reliable over five years, if they were based on positive criteria. The fear to miss a somatic process turns thus into a chimera.
担心在“功能性”障碍中漏诊躯体疾病过程，以及对转换障碍（冲突的躯体表现）和心理生理障碍（躯体症状和体征伴情感反应）诊断的阳性标准的忽视，导致通过排除躯体疾病来进行诊断。其后果是广泛而具有破坏性的检查程序，以及将整合躯体、心理和社会因素的诊断推迟7至8年。基于通过对患者采用生物-心理-社会方法收集的阳性标准，10例被诊断为患有转换障碍，22例患有心理生理障碍。五年后对这些患者进行了重新评估。在所有病例中均未出现躯体诊断结果，而这本可解释五年前最初的主诉症状。如果基于阳性标准，“转换障碍”和“心理生理障碍”的诊断在五年内被证明是可靠的。因此，担心漏诊躯体疾病过程变成了一种幻想。
