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病例报告:对伴有躯体症状障碍的持续性慢性盆腔疼痛综合征的新见解

Case report: New insights into persistent chronic pelvic pain syndrome with comorbid somatic symptom disorder.

作者信息

Huang JiChao, Zhong Yi, Duan Yu, Sun Jie

机构信息

Affiliated Shuyang Hospital of Nanjing University of Chinese Medicine, Suqian, Jiangsu, China.

NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China.

出版信息

Front Psychiatry. 2023 Jan 20;14:1119938. doi: 10.3389/fpsyt.2023.1119938. eCollection 2023.

Abstract

Chronic pelvic pain syndrome (CPPS) is generally defined as pain in the pelvic area that persisted for 3-6 months or longer. The pain can be constant or episodic and functionally disabling. Any dysfunction of the central nervous system can lead to central sensitization, which enhances and maintains pain as well as other symptoms that are mediated by the central nervous system. It occurs in subgroups of nearly every chronic pain condition and is characterized by multifocal pain and co-occurring somatic symptoms. Somatic symptom disorder (SSD) is defined as a condition in which having one or more somatic symptoms, such as excessive worries, pressure, and catastrophic events. These symptoms can be very disruptive to a patient's life and can cause significant distress. SSD cases with severe symptoms frequently undergo repeated medical investigations and the symptoms often lead patients to seek emergency medical treatment and consult with specialists repeatedly, which is a source of frustration for patients and clinicians. Here we report a case that Asian female with persistent CPPS with comorbid SSD, who got in trouble for up to 8 years. This case reminds clinicians to pay excessive attention to the diagnosis of CPPS with comorbid SSD after recovery from acute COVID-19, with hope of raising awareness in the identification of SSD and present new insight into appropriate treatment for each woman who suffers from it.

摘要

慢性盆腔疼痛综合征(CPPS)通常被定义为盆腔区域持续3至6个月或更长时间的疼痛。疼痛可以是持续性的或间歇性的,并且会导致功能障碍。中枢神经系统的任何功能障碍都可导致中枢敏化,从而增强并维持疼痛以及由中枢神经系统介导的其他症状。它几乎出现在每种慢性疼痛病症的亚组中,其特征为多灶性疼痛和同时出现的躯体症状。躯体症状障碍(SSD)被定义为一种存在一种或多种躯体症状的情况,例如过度担忧、压力和灾难性事件。这些症状会对患者的生活造成极大干扰,并可能导致严重困扰。症状严重的SSD病例经常接受反复的医学检查,这些症状还常常导致患者反复寻求紧急医疗救治并咨询专家,这对患者和临床医生来说都是令人沮丧的根源。在此,我们报告一例患有持续性CPPS并合并SSD的亚洲女性病例,她受此困扰长达8年。该病例提醒临床医生在急性COVID-19康复后要格外关注合并SSD的CPPS的诊断,以期提高对SSD识别的认识,并为每位患有该病症的女性提供适当治疗的新见解。

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Somatic Symptom Disorder and the Physician's Role.躯体症状障碍与医生的角色。
JAMA Pediatr. 2020 Oct 1;174(10):1000-1001. doi: 10.1001/jamapediatrics.2020.0165.
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New Insights about Chronic Pelvic Pain Syndrome (CPPS).慢性盆腔疼痛综合征(CPPS)的新见解。
Int J Environ Res Public Health. 2020 Apr 26;17(9):3005. doi: 10.3390/ijerph17093005.

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