Giupponi Giancarlo, Maniscalco Ignazio, Mathà Sandra, Ficco Carlotta, Pernther Georg, Sanna Livia, Pompili Maurizio, Kapfhammer Hans-Peter, Conca Andreas
Comprensorio Bolzano, Servizio Psichiatrico, Lorenz-Boehler-Straße 5, Bolzano, Italien.
Sant'Andrea-Krankenhaus, Sapienza Universität Rome, Grottarossa-Straße, 1035, Rome, Italien.
Neuropsychiatr. 2018 Mar;32(1):9-17. doi: 10.1007/s40211-017-0248-8. Epub 2017 Sep 22.
The somatoform disorders include a group of complex disorders consist of somatic symptoms for which there are no identifiable organic cause or pathogenetic mechanisms. Given the importance of these disorders and the need to clarify the diagnosis of somatoform disorder affecting the suicide risk, we took into consideration the scientific literature to investigate the correlation between the two conditions.
We performed a bibliographic search through Medline, Embase, PsycINFO, Scopus, SciELO, ORCID, Google Scholar, DOAJ using the following terms: somatoform, somatization disorder, pain disorder AND psychological factor, suicide, parasuicide, suicidality.
In all studies reported in our review, the suicidal behavior risk is high. But in the majority, the data are relatively unreliable because it takes into account the category nosographic "Neurotic, stress-related and somatoform disorders", too wide to be able to identify the clinical characteristics of patients at risk of only somatoform disorder.
Several studies conclude that psychiatric comorbidity increases the suicide risk: patients with two or more psychiatric disorders are more likely to commit a suicide attempt; in particular if there is a axis I diagnosis, the risk reduplicate. The somatization disorder seems to have a significant psychiatric comorbidity in particular with anxious and affective disorders spectrum.
躯体形式障碍包括一组复杂的疾病，其特征为存在无法明确识别的器质性病因或发病机制的躯体症状。鉴于这些疾病的重要性以及明确影响自杀风险的躯体形式障碍诊断的必要性，我们参考科学文献来研究这两种情况之间的相关性。
我们通过Medline、Embase、PsycINFO、Scopus、SciELO、ORCID、谷歌学术、DOAJ进行文献检索，使用了以下检索词：躯体形式、躯体化障碍、疼痛障碍以及心理因素、自杀、准自杀、自杀倾向。
在我们综述中报道的所有研究中，自杀行为风险都很高。但在大多数情况下，数据相对不可靠，因为其考虑了疾病分类学中的“神经症性、应激相关和躯体形式障碍”类别，该类别过于宽泛，无法仅识别有躯体形式障碍风险患者的临床特征。
多项研究得出结论，精神疾病共病会增加自杀风险：患有两种或更多种精神疾病的患者更有可能尝试自杀；特别是如果存在轴I诊断，风险会加倍。躯体化障碍似乎有显著的精神疾病共病，尤其是与焦虑和情感障碍谱系相关。
