Mabe P A, Jones L R, Riley W T
Department of Psychiatry & Health Behavior, Medical College of Georgia, Augusta.
Psychiatr Med. 1990;8(4):117-27.
Patients communicating psychological distress in the form of somatic symptoms and seeking medical care for them pose difficult diagnostic and treatment dilemmas for the primary care physician. Somatization may be conceptualized as an illness-focused behavior style, with multiple etiologies, rather than a single psychiatric disorder. Somatizing behavior is associated with emotional distress, cognitive-perceptual abnormalities, and socially learned illness behaviors. Although recognition of the somatizing patient begins with thorough medical evaluation, assessment should also include careful examination of social history and the affective meaning of symptoms. Management strategies will vary according to the etiology of the psychiatric diagnosis associated with physical symptoms; however, the essential element is provision of a long-term supportive relationship with a physician, who provides effective monitoring of physical and mental health status, appropriate emotional support, and reassurance concerning symptoms.
以躯体症状形式表达心理困扰并为此寻求医疗护理的患者，给初级保健医生带来了诊断和治疗上的难题。躯体化可被概念化为一种以疾病为中心的行为模式，有多种病因，而非单一的精神障碍。躯体化行为与情绪困扰、认知-感知异常以及社会习得的疾病行为相关。虽然对躯体化患者的识别始于全面的医学评估，但评估还应包括对社会史和症状情感意义的仔细检查。管理策略将根据与躯体症状相关的精神诊断的病因而有所不同；然而，关键要素是与医生建立长期的支持性关系，医生要对身心健康状况进行有效监测、给予适当的情感支持并就症状给予安心保证。
