Ishizuka Kosuke, Shikino Kiyoshi, Li Yu, Yokokawa Daiki, Tsukamoto Tomoko, Yanagita Yasutaka, Kojima Jumpei, Yamashita Shiho, Noda Kazutaka, Uehara Takanori, Ikusaka Masatomi
Department of General Medicine Chiba University Hospital Chiba Japan.
Department of General Medicine Yokohama City University School of Medicine Yokohama Japan.
J Gen Fam Med. 2023 Nov 29;25(2):110-111. doi: 10.1002/jgf2.661. eCollection 2024 Mar.
Diagnosis and management of psychogenic diseases such as conversion disorder, somatic symptom disorder (SSD), illness anxiety disorder, falsehood disorder, and psychotic disorder require an elaborate biopsychosocial approach and are often challenging. Herein, we propose the following points to differentiate medical diseases from these psychogenic diseases: correspondence between symptoms and objective findings or activities of daily living (ADL) impairment; placebo effect; clear provocative or palliative factors; progressive time course; paroxysmal or intermittent symptoms; unfamiliar but not strange expressions; symptoms worsen during sleep or rest.
转换障碍、躯体症状障碍（SSD）、疾病焦虑障碍、诈病障碍和精神障碍等心因性疾病的诊断和管理需要精心的生物心理社会方法，且往往具有挑战性。在此，我们提出以下几点以区分躯体疾病和这些心因性疾病：症状与客观检查结果或日常生活活动（ADL）受损之间的对应关系；安慰剂效应；明确的激发或缓解因素；渐进性病程；阵发性或间歇性症状；不熟悉但不奇怪的表现；症状在睡眠或休息时加重。
