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移民中躯体化的临床心理学视角:一项系统综述。

A Clinical-Psychological Perspective on Somatization Among Immigrants: A Systematic Review.

作者信息

Lanzara Roberta, Scipioni Mattia, Conti Chiara

机构信息

Department of Psychological, Health and Territorial Sciences, Università degli Studi G. d'Annunzio Chieti e Pescara, Chieti, Italy.

出版信息

Front Psychol. 2019 Jan 17;9:2792. doi: 10.3389/fpsyg.2018.02792. eCollection 2018.

Abstract

Somatic and psychopathological conditions (e.g., anxiety, depression, post-traumatic stress disorder, and somatization) are frequent among immigrants belonging to various ethnic groups. Worldwide findings on the epidemiology regarding specific mental conditions still vary with respect to different migration samples and migration contexts. This inconsistency also holds true in the incidence of somatization among migrants. We carried out a systematic review analyzing the relationship between migration and somatization by providing a qualitative data synthesis of original research articles on the topic. According to PRISMA guidelines, we conducted a systematic search of the literature on PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. The articles were selected using multiple combinations of relevant search terms (e.g., defined somatization and related disorders, and migration status). Each database was searched systematically from January 2000 to December 2017. The initial search identified 338 records, of which 42 research reports met the predefined inclusion criteria and were analyzed. Most studies ( = 38; 90%) were cross-sectional. The main findings of this study are that migrants with somatization exhibited more psychological distress, had an increased perceived need for healthcare service utilization, and reported more post-migration living difficulties and/or post-traumatic stress disorder than those without somatization. It was also found that specific individual features mediate the association between somatization and migration. The prevalence and correlates of somatization were found to vary across the immigrant groups, depending on cultural variation in reasons for migration, stress exposure, explanatory models of illness, coping, and other individual variables. Somatization is a challenge for health professionals due to its vague nature. In this regard, clinical management of immigrant patients should include further efforts to address emotional distress, with special attention to social, cultural, and linguistic differences.

摘要

躯体和精神病理状况(如焦虑、抑郁、创伤后应激障碍和躯体化障碍)在不同种族的移民中很常见。关于特定精神状况的全球流行病学研究结果在不同的移民样本和移民背景下仍存在差异。这种不一致在移民中躯体化障碍的发病率方面也同样存在。我们通过对该主题的原始研究文章进行定性数据综合分析,开展了一项系统评价,以分析移民与躯体化之间的关系。根据PRISMA指南,我们在PubMed、Scopus、ISI科学网、PsycINFO、谷歌学术和ScienceDirect上对文献进行了系统检索。使用相关检索词的多种组合(如定义的躯体化及相关障碍和移民身份)来筛选文章。每个数据库从2000年1月至2017年12月进行了系统检索。初步检索共识别出338条记录,其中42篇研究报告符合预先设定的纳入标准并进行了分析。大多数研究(n = 38;90%)为横断面研究。本研究的主要发现是,与未患躯体化障碍的移民相比,患躯体化障碍的移民表现出更多的心理困扰,对医疗服务利用的感知需求增加,且报告了更多的移民后生活困难和/或创伤后应激障碍。研究还发现,特定的个体特征介导了躯体化与移民之间的关联。躯体化障碍的患病率及其相关因素在不同移民群体中存在差异,这取决于移民原因、压力暴露、疾病解释模型、应对方式及其他个体变量的文化差异。由于躯体化障碍的性质模糊,它对卫生专业人员来说是一项挑战。在这方面,对移民患者的临床管理应包括进一步努力解决情绪困扰,特别关注社会、文化和语言差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4118/6344401/fcf742478c19/fpsyg-09-02792-g0001.jpg

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