Aragona Massimiliano, Ferrari Federica, Cavallo Marcella, Pierconti Silvia, Pajno Chiara, Coletta Paola, Barbarossa Giulia, Nicolella Gianluca, Laurendi Giovanna
National Institute for Health, Migration and Poverty (INMP), Rome, Italy.
Psychopathology. 2024;57(5):399-411. doi: 10.1159/000538460. Epub 2024 Jun 4.
Somatization in immigrants is frequent but standard studies do not differentiate between various forms of somatization. In this qualitative study, we used an idealtypical approach with the aim of phenomenologically differentiating between different forms of somatization in immigrants.
The clinical description of the ideal types was based on seven levels: medical examination; description of somatization symptoms; the patients' own interpretation of their somatic experience; concomitant psychopathological phenomena; genetic understanding; clinician's interpretation; and course and treatment.
Five different ideal typologies of patients emerged: anxious hypochondriasis, somatization with cultural features playing a pathogenetic role, culturally shaped somatization (through pathoplastic effects), somatization as part of adjustment reactions due to migratory living difficulties, and somatization as post-traumatic reaction.
These differences are useful to highlight the complex interrelationship between socioeconomic, migratory, cultural, and value factors in the construction of somatization among immigrants. Implications for research methodology, nosology, clinical management, and organization of medical facilities are also discussed.
移民中的躯体化现象很常见,但标准研究并未区分不同形式的躯体化。在这项定性研究中,我们采用了理想类型法,旨在从现象学角度区分移民中不同形式的躯体化。
理想类型的临床描述基于七个层面:医学检查;躯体化症状描述;患者对其躯体体验的自身解读;伴随的精神病理现象;遗传学理解;临床医生的解读;病程及治疗。
出现了五种不同的患者理想类型:焦虑性疑病症、文化特征在发病机制中起致病作用的躯体化、文化塑造的躯体化(通过病理塑形效应)、作为因移民生活困难而产生的适应反应一部分的躯体化、以及作为创伤后反应的躯体化。
这些差异有助于凸显社会经济、移民、文化和价值因素在移民躯体化形成过程中的复杂相互关系。还讨论了对研究方法、疾病分类学、临床管理和医疗设施组织的影响。