Zhang Gus, North Carol S
Department of Psychiatry, University of Texas Southwestern, Medical Center, Dallas, TX, USA E-mail:
Ann Clin Psychiatry. 2017 Aug;29(3):182-190.
There is little agreement about the association of somatization with exposure to disaster trauma in the existing literature.
Pre-disaster and post-disaster psychiatric disorders, somatization disorder, and individual somatoform (medically unexplained) symptoms were assessed with structured diagnostic interviews in 811 directly exposed survivors of 10 disasters.
Only 1 individual met criteria for post-disaster somatization disorder; there were no incident cases. Only 21% of all somatic symptoms reported were somatoform symptoms. Although 29% of the sample had ≥1 post-disaster somatoform symptoms, only 13% of the sample had any incident somatoform symptoms, and only 1.5% of the sample had >1.
Somatization disorder is not an observed outcome of disaster. Incidence of individual somatoform symptoms is relatively uncommon and represents a construct that is distinct from somatization disorder. Such symptoms appear to represent nonspecific distress or endemic symptoms in the population and are not necessarily causally related to the disaster. The only studies that have identified somatization symptoms in relation to disaster have used nondiagnostic symptom checklists. As illustrated by the findings from this study, nondiagnostic symptom checklists do not adequately substitute for structured diagnostic instruments in assessment of somatoform psychopathology.
在现有文献中，关于躯体化与灾难创伤暴露之间的关联几乎没有一致的看法。
通过结构化诊断访谈，对10起灾难的811名直接暴露幸存者的灾前和灾后精神障碍、躯体化障碍及个体躯体形式（医学无法解释的）症状进行评估。
只有1名个体符合灾后躯体化障碍的标准；无新发病例。报告的所有躯体症状中只有21%是躯体形式症状。虽然29%的样本有≥1种灾后躯体形式症状，但只有13%的样本有任何新发躯体形式症状，只有1.5%的样本有超过1种。
躯体化障碍不是灾难的一个观察结果。个体躯体形式症状的发生率相对不常见，代表一种与躯体化障碍不同的结构。此类症状似乎代表人群中的非特异性痛苦或地方性症状，不一定与灾难有因果关系。唯一确定与灾难相关的躯体化症状的研究使用的是非诊断性症状清单。正如本研究结果所示，在评估躯体形式精神病理学方面，非诊断性症状清单不能充分替代结构化诊断工具。
