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躯体化:将心理困扰体验并表达为躯体症状。

Somatization: the experience and communication of psychological distress as somatic symptoms.

作者信息

Lipowski Z J

机构信息

Clark Institute of Psychiatry, Toronto, Ont., Canada.

出版信息

Psychother Psychosom. 1987;47(3-4):160-7. doi: 10.1159/000288013.

Abstract

Somatization implies a tendency to experience and communicate psychological distress in the form of somatic symptoms and to seek medical help for them. So defined, it is neither a disorder nor a diagnostic category but a generic term for a set of experimental, cognitive, and behavioral characteristics of patients who complain of physical symptoms in the absence of relevant medical findings. Such patients are ubiquitous in all medical care settings, pose difficult diagnostic and management problems, and overutilize health care thus contributing to its cost. Somatization may be transient or persistent, and may or may not be associated with a diagnosable medical or psychiatric disorder. The most common concurrence of somatization is with affective and anxiety disorders, and, to a lesser degree, the somatoform disorders. Persistent somatization poses a serious clinical, social, and economic problem and hence early identification of potential chronic somatizers should be attempted to avoid its development. Pain, fatigue, dizziness, and dyspnea are the commonest symptoms. Etiology of somatization is multifactorial and so should be its management.

摘要

躯体化是指倾向于以躯体症状的形式体验和表达心理困扰,并因此寻求医疗帮助。如此定义的话,它既不是一种疾病,也不是一个诊断类别,而是一个通用术语,用于描述那些在没有相关医学发现的情况下抱怨躯体症状的患者的一系列实验性、认知性和行为性特征。这类患者在所有医疗环境中都很常见,会带来诊断和管理方面的难题,并且过度使用医疗服务,从而增加了医疗成本。躯体化可能是短暂的,也可能是持续的,可能与可诊断的医学或精神疾病有关,也可能无关。躯体化最常见的并发情况是与情感障碍和焦虑障碍,以及程度较轻的躯体形式障碍。持续性躯体化构成了严重的临床、社会和经济问题,因此应尝试早期识别潜在的慢性躯体化患者,以避免其发展。疼痛、疲劳、头晕和呼吸困难是最常见的症状。躯体化的病因是多因素的,其管理也应如此。

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