Kellner R
Arch Gen Psychiatry. 1985 Aug;42(8):821-33. doi: 10.1001/archpsyc.1985.01790310089012.
Empirical studies suggest the following main conclusions: functional somatic symptoms are extremely common; a large proportion appear to be caused by physiologic activity and tend to be aggravated by emotion. Hypochondriacal patients misunderstand the nature and significance of these symptoms and believe that they are evidence of serious disease. Hypochondriasis can be a part of another syndrome, usually an affective one, or it can be a primary disorder. The prevalence differs between cultures and social classes. Constitutional factors, disease in the family in childhood, and previous disease predispose to hypochondriasis. Various stressors can be precipitating events. Selective perception of symptoms, motivated by fear of disease, and subsequent increase in anxiety with more somatic symptoms appear to be links in the vicious cycle of the hypochondriacal reaction. Psychotherapy as well as psychotropic drugs are effective in the treatment of functional somatic symptoms. There are no adequate controlled studies of psychotherapy in hypochondriasis, and the recommended treatments are based on studies with similar disorders. The prognosis of treated hypochondriasis is good in a substantial proportion of patients.
功能性躯体症状极为常见；很大一部分似乎由生理活动引起，并往往因情绪而加重。疑病症患者误解了这些症状的性质和意义，认为它们是严重疾病的证据。疑病症可以是另一种综合征（通常是情感性综合征）的一部分，也可以是一种原发性疾病。患病率在不同文化和社会阶层中有所不同。体质因素、童年时期家族中的疾病以及既往疾病易引发疑病症。各种压力源可能是促发事件。因对疾病的恐惧而对症状的选择性感知，以及随后随着更多躯体症状而出现的焦虑增加，似乎是疑病症反应恶性循环中的环节。心理治疗以及精神药物对功能性躯体症状的治疗有效。目前尚无关于疑病症心理治疗的充分对照研究，推荐的治疗方法是基于对类似疾病的研究。相当一部分接受治疗的疑病症患者预后良好。
