University of California, San Diego, USA.
The University of British Columbia, Canada.
Clin Child Psychol Psychiatry. 2020 Jul;25(3):604-609. doi: 10.1177/1359104520905065. Epub 2020 Feb 19.
Somatic symptom disorder is a complex condition linking distress in the mind to physical distress in the body. However, in addition to the disorder itself, experienced clinicians know that children and youth frequently experience somatizing symptoms. With an increasing prevalence of anxiety in the pediatric population, symptoms attributable to process of "somatizing" are common, and early identification and rapport building to address the root causes of a child's distress are critical for a good outcome. In the acute care setting, clinicians are often reluctant to make the diagnosis of somatization. Part of the challenge is encouraging clinicians to see that somatization is not a "diagnosis of exclusion." We want to encourage clinicians to routinely consider risk factors for somatization in their histories, actively discuss the mind-body connection with patients and families, and include somatization in a carefully considered differential diagnosis. The more we can break down the siloing of physical from mental health, the better we will serve our patients.
躯体症状障碍是一种将精神痛苦与身体痛苦联系起来的复杂病症。然而，除了这种障碍本身之外，有经验的临床医生知道，儿童和青少年经常会出现躯体化症状。由于儿科人群中焦虑症的患病率不断增加，归因于“躯体化”过程的症状很常见，早期识别和建立关系以解决儿童痛苦的根本原因对于取得良好的治疗效果至关重要。在急性护理环境中，临床医生往往不愿意做出躯体化的诊断。部分挑战在于鼓励临床医生认识到躯体化不是一种“排除性诊断”。我们希望鼓励临床医生在病史中常规考虑躯体化的危险因素，积极与患者和家属讨论身心联系，并将躯体化纳入精心考虑的鉴别诊断中。我们越能打破身体和心理健康之间的隔阂，我们就能越好地为患者服务。
