Ludot-Grégoire Maude, Harf Aurélie, Ibrahim Nour, Merlo Médérick, Hassler Christine, Rietsch Joanne, de Bucy Charlotte, Lefèvre Hervé, Sibeoni Jordan, Moro Marie Rose
APHP, Hôpital Cochin, Maison de Solenn, 97 bv de Port Royal, 75014, Paris, France.
Université de Paris, PCPP, 71 av. Edouard Vaillant, 92100, Boulogne-Billancourt, France.
Child Adolesc Psychiatry Ment Health. 2022 Jun 3;16(1):40. doi: 10.1186/s13034-022-00476-9.
The bodily expression of psychological disorders is one of the leading motives for consultations in adolescent medicine. The diagnostic entity corresponding to DSM-5 "Somatic symptom and related disorders" is sparsely used in the English-language literature, especially for adolescents. Qualitative studies on this topic mostly concern the experiences of healthcare professionals. This study seeks to explore the experience of adolescents expressing psychological distress through their body.
This exploratory research took place in a Paris hospital department of adolescent medicine. Our sampling method was purposive. For inclusion, patients had to be aged 11-24 years, with a "somatic symptom disorder" meeting the DSM-5 criteria. Semi-directive interviews were proposed with visual narration inspired by photoelicitation. Thematic analysis allowed us to explore the data with an inductive approach.
Thirty adolescents were interviewed; they were 14-22 years old and mostly had somatic symptom or functional neurological disorders. Three principal themes emerged from our analysis of the interview contents: the personal, including bodily, experience of the disorder, the experience of relationships, and the question of what is visible through the body.
This research allowed us to discuss the reversal of generations, the function of the DSM-5 diagnosis, illuminated by sociology, and finally, cultural pathways. It shows the importance of recognizing the reality of the adolescents' bodily feelings, reassuring them by ruling out serious causes, and supporting their search for meaning. It is important to think about a specific framework of family therapy that can make effective use of this experience of the reversal of generations.
心理障碍的身体表现是青少年医学咨询的主要动机之一。与《精神疾病诊断与统计手册》第五版（DSM - 5）中“躯体症状及相关障碍”相对应的诊断实体在英语文献中使用较少，尤其是针对青少年群体。关于这一主题的定性研究大多关注医疗保健专业人员的经验。本研究旨在探索青少年通过身体表达心理困扰的经历。
这项探索性研究在巴黎一家医院的青少年医学科室进行。我们采用的抽样方法是立意抽样。纳入标准为年龄在11 - 24岁之间、符合DSM - 5标准的“躯体症状障碍”患者。我们采用了受照片诱导启发的视觉叙述方式进行半指导性访谈。主题分析使我们能够以归纳法探索数据。
共访谈了30名青少年，他们的年龄在14 - 22岁之间，主要患有躯体症状或功能性神经障碍。通过对访谈内容的分析，出现了三个主要主题：该障碍的个人经历，包括身体方面的经历；人际关系的经历；以及通过身体可观察到的问题。
这项研究使我们能够讨论代际逆转、社会学所阐明的DSM - 5诊断的功能，以及最后的文化路径。它表明了认识到青少年身体感受的现实、通过排除严重病因来安抚他们以及支持他们寻找意义的重要性。思考一种能够有效利用这种代际逆转经验的家庭治疗特定框架非常重要。
