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躯体症状障碍早期诊断的重要性:一例病例报告

The Importance of Early Diagnosis of Somatic Symptom Disorder: A Case Report.

作者信息

Sardesai Atharv, Muneshwar Komal N, Bhardwaj Mridul, Goel Dev B

机构信息

Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2023 Sep 2;15(9):e44554. doi: 10.7759/cureus.44554. eCollection 2023 Sep.

Abstract

A somatic symptom disorder (SSD) diagnosis is made when a person places emphasis on physical symptoms such as pain, exhaustion, or shortness of breath so much that it causes significant suffering and/or functional issues. The individual's thoughts, sentiments, and activities are an overstated reaction to such symptoms. Regardless of whether the physical symptoms are connected to a diagnosable medical condition, the person experiences symptoms and believes they are ill. When a person exhibits symptoms that satisfy the diagnostic standards of an SSD, the disease should be identified. However, due to the disorder's frequent co-occurrence, particularly with anxiety and depressive disorders, support for these concurrent diagnoses should be sought. Cognitive-behavioral therapy, mindfulness-based therapy, and medication are all examples of effective treatments for SSD. It has been demonstrated that tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) aid in treating symptoms. The authors describe the case of an eight-year-old boy with complaints of abdominal pain that were unexplained by various tests. The pain lasted 10 years and was episodic (each episode lasted around 10 days; one particular episode lasted approximately six months). Multiple investigations were conducted, but no physiological reason for his symptoms was discovered. His evaluation was conducted by an interdisciplinary team that included neurologists, psychiatrists, surgeons, and doctors. The underlying cause was subsequently determined to be SSD. As people with SSD present to general practitioners and the emergency room rather than psychiatric facilities, this incident serves as a sobering reminder of the need to advocate for an accurate diagnosis of this condition.

摘要

当一个人过度强调身体症状(如疼痛、疲惫或呼吸急促),以至于造成严重痛苦和/或功能问题时,就会做出躯体症状障碍(SSD)的诊断。个体的思想、情感和行为是对这些症状的过度反应。无论身体症状是否与可诊断的医疗状况相关,此人都会体验到症状并认为自己生病了。当一个人表现出符合SSD诊断标准的症状时,就应该识别出这种疾病。然而,由于该障碍经常并发,尤其是与焦虑症和抑郁症并发,因此应寻求对这些并发诊断的支持。认知行为疗法、正念疗法和药物治疗都是SSD的有效治疗方法。已经证明三环类抗抑郁药或选择性5-羟色胺再摄取抑制剂(SSRI)有助于治疗症状。作者描述了一名8岁男孩的病例,他主诉腹痛,但各种检查均未找到病因。疼痛持续了10年,呈发作性(每次发作持续约10天;有一次特别发作持续了大约6个月)。进行了多项检查,但未发现其症状的生理原因。对他的评估由一个跨学科团队进行,该团队包括神经科医生、精神科医生、外科医生和内科医生。随后确定其根本原因是SSD。由于SSD患者常去全科医生处和急诊室就诊,而非精神科机构,这一事件令人警醒地提醒人们,必须倡导对这种疾病进行准确诊断。

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