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"Lumping" and "splitting" medically unexplained symptoms: is there a role for a transdiagnostic approach?对医学上无法解释的症状进行“合并”与“细分”:跨诊断方法是否能发挥作用?
J Ment Health. 2017 Jun;26(3):187-191. doi: 10.1080/09638237.2017.1322187. Epub 2017 May 9.
2
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Emerg Nurse. 2011 Dec 7;19(8):11. doi: 10.7748/en.19.8.11.s7.
3
Symptoms as the main problem in primary care: A cross-sectional study of frequency and characteristics.以症状为主要问题的基层医疗:一项关于频率和特征的横断面研究。
Scand J Prim Health Care. 2015 Jun;33(2):91-9. doi: 10.3109/02813432.2015.1030166. Epub 2015 May 11.
4
The negotiation of the sick role: general practitioners' classification of patients with medically unexplained symptoms.患病角色的协商:全科医生对患有无法解释症状的患者的分类。
Sociol Health Illn. 2012 Sep;34(7):1025-38. doi: 10.1111/j.1467-9566.2011.01448.x. Epub 2012 Mar 5.
5
Towards a sociology of diagnosis: reflections and opportunities.迈向诊断社会学:反思与机遇
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6
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7
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8
Medically unexplained symptoms--blurring the line between "mental" and "physical" in somatoform disorders.医学上无法解释的症状——在躯体形式障碍中模糊了“精神”与“身体”之间的界限。
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9
Are somatoform disorders changing with time? The case of neurasthenia in China.躯体形式障碍会随时间变化吗?以中国的神经衰弱为例。
Psychosom Med. 2007 Dec;69(9):846-9. doi: 10.1097/PSY.0b013e31815b0092.
10
Contested boundaries: psychiatry, disease, and diagnosis.有争议的界限:精神病学、疾病与诊断
Perspect Biol Med. 2006 Summer;49(3):407-24. doi: 10.1353/pbm.2006.0046.

名字里有什么?台湾的自主神经失衡和医学无法解释的症状。

What is in a name? Autonomic imbalance and medically unexplained symptoms in Taiwan.

机构信息

Institute of Science, Technology and Society, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

Sociol Health Illn. 2021 May;43(4):881-894. doi: 10.1111/1467-9566.13262. Epub 2021 Mar 13.

DOI:10.1111/1467-9566.13262
PMID:33713482
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8359945/
Abstract

Medically unexplained symptoms (MUS) are persistent bodily symptoms without known pathology. An unofficial term has recently emerged in Taiwan to accommodate MUS: autonomic imbalance (AI). AI literally refers to disturbances of the autonomic nervous system (ANS) that innervates vital organs. However, AI is variously conceptualised by different parties. This study intends to investigate what is in the name of AI. It draws on available databases and in-depth interviews with AI sufferers and Western and Chinese medicine physicians. Some physicians research ANS functions through heart rate variability measurements. Research findings show that physicians regard AI as a convenient term for clinical communication and a euphemistic substitute for MUS or even psychiatric diagnoses. It is not a 'real thing'. However, AI sufferers treat AI as a bona fide disease, only that it has not been officially classified. AI is therefore an unfaithful translation, or an uncontrolled equivocation, of MUS. The paper concludes by discussing the implications of treating AI as an equivocation. These implications include the limitations of the current diagnostic criteria, the necessity to rethink the dichotomy of mind and body, and the underlying realities exposed or masked by 'diagnosis'.

摘要

未明原因的躯体症状(MUS)是指持续存在的、没有已知病理的躯体症状。台湾地区最近出现了一个非官方术语来涵盖 MUS:自主神经失衡(AI)。AI 字面意思是指支配重要器官的自主神经系统(ANS)的紊乱。然而,不同的人对 AI 的概念理解各不相同。本研究旨在探讨 AI 这个名称所代表的含义。它借鉴了现有的数据库以及对 AI 患者、西方和中医医生的深入访谈。一些医生通过心率变异性测量来研究 ANS 功能。研究结果表明,医生将 AI 视为临床交流的便捷术语,是 MUS 甚至精神科诊断的委婉替代,而不是“真实存在的东西”。然而,AI 患者将 AI 视为一种真实的疾病,只是它尚未被正式分类。因此,AI 是对 MUS 的一种不忠实的翻译,或者说是一种不受控制的模棱两可。本文最后讨论了将 AI 视为模棱两可的含义。这些含义包括当前诊断标准的局限性、需要重新思考身心二分法,以及“诊断”所揭示或掩盖的潜在现实。