Hall Nicoline M, Kuzminskyte Ruta, Pedersen Anders D, Ørnbøl Eva, Fink Per
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospitals, Denmark.
Nord J Psychiatry. 2011 Jun;65(3):216-24. doi: 10.3109/08039488.2010.528024. Epub 2010 Nov 9.
Patients with multiple functional somatic symptoms (MFS) often express cognitive complaints. The aim of this descriptive study was to investigate whether these patients have cognitive deficits and whether the patients' cognitive functioning relates to their experience of physical and psychological distress and to their use of pain-related coping strategies.
Neuropsychological assessment of verbal ability, psychomotor speed, attention, working memory, perceptual organization and memory, was conducted on 22 MFS patients and 27 healthy age- and gender-matched controls. Psychological distress, health anxiety, health status and pain coping were measured with questionnaires [Symptom Checklist 90-Revised (SCL-somatization, SCL-depression, SCL-anxiety), the Whiteley-7 scale, the Short Form (SF-36) and the Coping Strategies Questionnaire (CSQ)].
For patients, a high score on the SCL-somatization subscale was associated with poor performance on tests of attention and psychomotor speed, and with a high score on the coping scale Increasing behavioural activities. A high score on this coping scale was associated with poor performance on tests of verbal ability and executive functioning. After controlling for years of education, controls performed significantly better than patients on verbal as well as performance IQ scales but not on tests of memory.
In the present study, we found that physical complaints are related to deficits in attention and psychomotor speed. Moreover, our results suggest that poor verbal skills may play a role in the development of MFS because of an increased tendency to apply behavioural/avoidant coping strategies. We suggest that treatment of MFS should involve training of attention as well as practicing the use of cognitive coping strategies.
患有多种功能性躯体症状（MFS）的患者常表现出认知方面的主诉。这项描述性研究的目的是调查这些患者是否存在认知缺陷，以及患者的认知功能是否与其身体和心理痛苦体验以及与疼痛相关的应对策略的使用有关。
对22名MFS患者和27名年龄及性别匹配的健康对照者进行了言语能力、心理运动速度、注意力、工作记忆、知觉组织和记忆的神经心理学评估。使用问卷[症状自评量表90修订版（SCL-躯体化、SCL-抑郁、SCL-焦虑）、怀特利7量表、简短健康调查问卷（SF-36）和应对策略问卷（CSQ）]测量心理痛苦、健康焦虑、健康状况和疼痛应对情况。
对于患者而言，SCL-躯体化分量表上的高分与注意力和心理运动速度测试中的不佳表现相关，并且与应对量表“增加行为活动”上的高分相关。该应对量表上的高分与言语能力和执行功能测试中的不佳表现相关。在控制受教育年限后，对照组在言语智商和操作智商量表上的表现明显优于患者，但在记忆测试中并非如此。
在本研究中，我们发现身体主诉与注意力和心理运动速度缺陷有关。此外，我们的结果表明，由于应用行为/回避应对策略的倾向增加，较差的言语技能可能在MFS的发展中起作用。我们建议，MFS的治疗应包括注意力训练以及认知应对策略的使用练习。
