Henningsen Peter
Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Germany.
Dialogues Clin Neurosci. 2018 Mar;20(1):23-31. doi: 10.31887/DCNS.2018.20.1/phenningsen.
This review paper gives an overview of the management of somatic symptom disorder. It starts with a description of the clinical problem of patients with persistent bodily distress, discusses classificatory, epidemiological, and etiological issues and then describes the evidence and practical principles of dealing with these patients who are often seen as "difficult" to treat. It is concluded that the best-suited approach is stepped care with close cooperation of primary care, a somatic specialist, and mental health care professionals operating on the basis of a biopsychosocial model of integrating somatic as well as psychosocial determinants of distress and therapeutic factors.
这篇综述文章概述了躯体症状障碍的管理。文章开篇描述了持续性身体不适患者的临床问题，讨论了分类、流行病学和病因学问题，然后阐述了应对这些常被视为“难治”患者的证据和实践原则。文章得出结论，最合适的方法是采用分级护理，由初级保健医生、躯体专科医生和心理健康护理专业人员密切合作，基于生物心理社会模型开展工作，该模型整合了身体不适以及心理社会方面的痛苦决定因素和治疗因素。
