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基层医疗中对具有医学上无法解释症状患者的治疗:文献综述

The treatment of patients with medically unexplained symptoms in primary care: a review of the literature.

作者信息

Edwards Todd M, Stern Anthony, Clarke David D, Ivbijaro Gabriel, Kasney L Michelle

机构信息

Associate Professor of Marital and Family Therapy, University of San Diego, San Diego, CA, USA.

出版信息

Ment Health Fam Med. 2010 Dec;7(4):209-21.

PMID:22477945
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3083260/
Abstract

Medically unexplained symptoms (MUS) are among the most common and frustrating in primary care. Our goal was to review published evidence to guide busy general practitioners working with a culturally diverse, challenging patient population coping with MUS. A search of PubMed and PsycINFO from 1985 to the present was conducted using MUS and related terms.The literature was then organised into subcategories based on its relevance to primary care. We conclude with a description of gaps in the literature based on the literature review and the clinical experience of the authors.

摘要

医学上无法解释的症状(MUS)是基层医疗中最常见且令人沮丧的问题之一。我们的目标是回顾已发表的证据,以指导忙碌的全科医生,他们面对的是具有文化多样性、难以应对MUS的患者群体。使用MUS及相关术语对1985年至今的PubMed和PsycINFO进行了检索。然后根据文献与基层医疗的相关性将其分为不同类别。基于文献综述和作者的临床经验,我们最后描述了文献中的空白之处。

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The treatment of patients with medically unexplained symptoms in primary care: a review of the literature.基层医疗中对具有医学上无法解释症状患者的治疗:文献综述
Ment Health Fam Med. 2010 Dec;7(4):209-21.
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本文引用的文献

1
Public Pressure, Private Protest: Illness Narratives of West Indian Immigrants in Montreal with Medically Unexplained Symptoms.公众压力,私下抗议:蒙特利尔有医学上无法解释症状的西印度移民的疾病叙事
Anthropol Med. 2006 Dec;13(3):193-205. doi: 10.1080/13648470600863548.
2
The cost of somatisation among the working-age population in England for the year 2008-2009.2008 - 2009年英格兰劳动年龄人口中躯体化障碍的成本。
Ment Health Fam Med. 2010 Jun;7(2):71-84.
3
Somatisation and alexithymia in patients with high use of medical care and medically unexplained symptoms.医疗服务高利用率且有医学无法解释症状患者的躯体化和述情障碍
Ment Health Fam Med. 2008 Sep;5(3):139-48.
4
Psychological approaches to origins and treatments of somatoform disorders.心理方法探究躯体形式障碍的起源与治疗。
Annu Rev Clin Psychol. 2010;6:257-83. doi: 10.1146/annurev.clinpsy.121208.131505.
5
Patients with medically unexplained symptoms and their significant others: illness attributions and behaviors as predictors of patient functioning over time.患有无法用医学解释的症状的患者及其重要他人:疾病归因和行为是预测患者随时间推移的功能的指标。
J Psychosom Res. 2010 Mar;68(3):253-62. doi: 10.1016/j.jpsychores.2009.09.012. Epub 2009 Dec 9.
6
Somatisation in primary care: experiences of primary care physicians involved in a training program and in a randomised controlled trial.初级保健中的躯体化:参与培训计划和随机对照试验的初级保健医生的经验。
BMC Fam Pract. 2009 Nov 25;10:73. doi: 10.1186/1471-2296-10-73.
7
Intensive short-term dynamic psychotherapy to reduce rates of emergency department return visits for patients with medically unexplained symptoms: preliminary evidence from a pre-post intervention study.强化短期动态心理治疗以降低医学上无法解释症状患者的急诊科复诊率:一项干预前后研究的初步证据。
CJEM. 2009 Nov;11(6):529-34. doi: 10.1017/s1481803500011799.
8
Medically unexplained physical symptoms in primary care: a controlled study on the effectiveness of cognitive-behavioral treatment by the family physician.基层医疗中的医学无法解释的躯体症状:家庭医生进行认知行为治疗的对照研究。
Psychosomatics. 2009 Sep-Oct;50(5):515-24. doi: 10.1176/appi.psy.50.5.515.
9
Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study.解释与关系。全科医生如何处理患有持续性医学无法解释症状的患者:一项焦点小组研究。
BMC Fam Pract. 2009 Sep 24;10:68. doi: 10.1186/1471-2296-10-68.
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In their own words: qualitative study of high-utilising primary care patients with medically unexplained symptoms.用他们自己的话来说:对有医学上无法解释症状的高就诊率初级保健患者的定性研究
BMC Fam Pract. 2009 Sep 21;10:67. doi: 10.1186/1471-2296-10-67.