Ginsberg B I, Wallack J J, Srain J J, Biller H F
Division of Liaison Psychiatry, Mt. Sinai Medical Center, New York.
Gen Hosp Psychiatry. 1988 Mar;10(2):132-7. doi: 10.1016/0163-8343(88)90099-0.
The authors evaluated 11 surgically-treated patients with spastic dysphonia, a phonation disorder of unclear etiology. The results indicate that the illness does not appear to be a somatoform disorder, but that stress may play a role in its expression, and that there may be secondary depression and anxiety. The experience of spastic dysphonics suggests that psychiatric treatments may be inappropriately applied to an illness without clear organic etiology, whereas, conversely, a proper psychiatric role may be rejected when effective medical or surgical treatment is available. The authors recommend that psychiatrists evaluating patients with illnesses of unclear etiology should be cautious in making a primary psychiatric diagnosis unless DSM-III criteria are met.
作者评估了11例接受手术治疗的痉挛性发声障碍患者，这是一种病因不明的发声障碍。结果表明，该疾病似乎并非躯体形式障碍，但压力可能在其症状表现中起作用，且可能存在继发性抑郁和焦虑。痉挛性发声障碍患者的经历表明，对于病因不明的疾病，精神科治疗可能应用不当，而相反，当有有效的药物或手术治疗时，适当的精神科作用可能被忽视。作者建议，评估病因不明疾病患者的精神科医生在做出原发性精神科诊断时应谨慎，除非符合《精神疾病诊断与统计手册》第三版（DSM-III）的标准。
