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家庭医疗中的躯体化障碍

Somatization disorder in a family practice.

作者信息

deGruy F, Columbia L, Dickinson P

出版信息

J Fam Pract. 1987 Jul;25(1):45-51.

PMID:3598478
Abstract

Somatization disorder is a condition characterized by multiple unexplained complaints. This study was done to determine the prevalence of somatization disorder in a family practice office setting, to characterize the patients so affected, and to assess their impact on the practice. A sample of ill patients was interviewed, of whom 6 (5 percent) had definite somatization disorder and another 4 (4 percent) had borderline somatization disorder (ten or more symptoms). All were women, and they were more likely than controls to live in households with children but no spouse (P less than .01). They were also more likely than their unaffected counterparts to be from the lowest two social classes (P less than .01). Compared with matched controls, their rate of office visits and charges incurred was about 50 percent greater (.58 visits per month vs .41 visits per month; $23.28 per month vs $14.44 per month). Their charts were thicker (7 cm vs 3.6 cm) and heavier (3076 g vs 1843 g) and had more diagnoses (85 vs 51) than controls. The physicians of the somatizers were significantly less satisfied with the care rendered to them than to the controls (P less than .01). This study demonstrates that somatization disorder is a prevalent, expensive, and difficult problem for family physicians.

摘要

躯体化障碍是一种以多种无法解释的症状为特征的疾病。本研究旨在确定家庭医疗诊所中躯体化障碍的患病率,描述受该疾病影响的患者特征,并评估其对诊所的影响。对一组患病患者进行了访谈,其中6人(5%)患有明确的躯体化障碍,另外4人(4%)患有边缘性躯体化障碍(有十种或更多症状)。所有患者均为女性,与对照组相比,她们更有可能生活在有孩子但没有配偶的家庭中(P<0.01)。她们也比未受影响的同龄人更有可能来自社会最低的两个阶层(P<0.01)。与匹配的对照组相比,她们的门诊就诊率和费用支出高出约50%(每月0.58次就诊vs每月0.41次就诊;每月23.28美元vs每月14.44美元)。她们的病历更厚(7厘米vs 3.6厘米)、更重(3076克vs 1843克),诊断也比对照组更多(85个vs 51个)。躯体化障碍患者的医生对为他们提供的治疗的满意度明显低于对照组(P<0.01)。这项研究表明,躯体化障碍对家庭医生来说是一个普遍、昂贵且棘手的问题。

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