Wright A F
Br J Gen Pract. 1990 Nov;40(340):459-63.
A computerized questionnaire was used to collect information on the presentation of symptoms in all 125 new patients presenting to one general practitioner in the course of one year who were considered to be suffering clinically significant psychiatric disturbance. Comparison was made between the 73 (58%) patients presenting with psychological symptoms and the 52 (42%) patients presenting with somatic symptoms for which no physical explanation was evident at the time of the consultation. Important differences emerged between the groups. Those patients presenting somatic symptoms had lower scores on the tests of psychiatric distress (indicating severity), fewer individual symptoms and fewer severe symptoms than patients presenting with psychological problems. This group also had statistically significant differences in personality profile and reported significantly fewer social problems. Prognosis for both groups was similar in that patients in both groups were equally likely to have a normal psychiatric distress score after six months. Adequate management of somatizing patients calls for vigilance and for improved detection and negotiating skills. Reviewing the computer results with patients helped them discuss their symptoms and the system allowed the general practitioner not only a clinical assessment of these patients' problems but a measure of psychological, social and personality components.
使用一份计算机化问卷收集了一年中到一位全科医生处就诊的125名新患者的症状表现信息，这些患者被认为患有具有临床意义的精神障碍。对73名（58%）出现心理症状的患者和52名（42%）出现躯体症状的患者进行了比较，在会诊时这些躯体症状没有明显的身体原因。两组之间出现了重要差异。与出现心理问题的患者相比，出现躯体症状的患者在精神痛苦测试（表明严重程度）中的得分较低，个体症状较少，严重症状也较少。这组患者在人格特征方面也有统计学上的显著差异，报告的社会问题也明显较少。两组的预后相似，两组患者在六个月后精神痛苦得分正常的可能性相同。对躯体化患者进行充分管理需要警惕，并提高检测和沟通技巧。与患者一起查看计算机结果有助于他们讨论自己的症状，该系统使全科医生不仅能够对这些患者的问题进行临床评估，还能衡量心理、社会和人格成分。
