Roenneberg Casper, Henningsen Peter, Hausteiner-Wiehle Constanze
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.
Zentrum für interdisziplinäre Schmerztherapie, Klinikum rechts der Isar, TU München, München, Deutschland.
Nervenarzt. 2020 Jul;91(7):651-661. doi: 10.1007/s00115-020-00917-w.
Somatic symptoms including pain are everyday human experiences. They usually result from a complex interaction of stimuli, interpretation and reaction, and are not necessarily proportional to structural damage. Persistent functional somatic symptoms can be associated with a significant impairment of quality of life and functioning, even without mental or somatic comorbidity. Dysfunctional experiences, expectancies and behavior, not only by patients but also by physicians, can increase the risk of chronification. From the outset, management should be graded with respect to the severity and biopsychosocial aspects, with thorough but cautious diagnostics and with psychoeducative, active and coping-oriented treatment.
包括疼痛在内的躯体症状是人类的日常体验。它们通常源于刺激、解读和反应的复杂相互作用，不一定与结构损伤成正比。即使没有精神或躯体合并症，持续性功能性躯体症状也可能与生活质量和功能的显著受损有关。不仅患者，医生的功能失调经历、预期和行为也会增加症状慢性化的风险。从一开始，管理就应根据严重程度和生物心理社会因素进行分级，进行全面但谨慎的诊断，并采用心理教育、积极和以应对为导向的治疗方法。
