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在躯体症状障碍管理中整合精神病学与家庭医学:诊断、协作及沟通策略

Integrating psychiatry and family medicine in the management of somatic symptom disorders: Diagnosis, collaboration, and communication strategies.

作者信息

Ajluni Victor

机构信息

Wayne State University Livonia Michigan USA.

出版信息

J Gen Fam Med. 2024 Oct 28;26(1):12-18. doi: 10.1002/jgf2.725. eCollection 2025 Jan.

Abstract

Somatic symptom disorders (SSDs) present a complex interplay of physical and psychological factors, necessitating an integrative approach to diagnosis and management. This article explores the collaborative efforts between family medicine and psychiatry in addressing SSDs, emphasizing the importance of a multidisciplinary strategy for comprehensive patient care. Effective diagnosis involves recognizing the significance of both somatic symptoms and the patient's psychological response, with tools like structured clinical interviews and self-report questionnaires playing crucial roles. Management strategies include psychotherapeutic interventions such as cognitive behavioral therapy (CBT), pharmacological treatments, and lifestyle modifications, all tailored to the patient's needs. Communication strategies are vital in validating patients' experiences while addressing underlying psychiatric issues. Techniques such as active listening, biopsychosocial framing, and the teach-back method foster trust and improve treatment adherence. Cultural considerations and the use of interpreters enhance communication with diverse patient populations. Training programs for healthcare providers further improve competency in managing SSDs. This integrative approach aims to enhance patient outcomes by addressing the multifaceted nature of SSDs through collaborative care, effective communication, and comprehensive treatment planning.

摘要

躯体症状障碍(SSDs)呈现出生理和心理因素的复杂相互作用,因此需要一种综合的诊断和管理方法。本文探讨了家庭医学和精神病学在应对躯体症状障碍方面的合作努力,强调了多学科策略对于全面患者护理的重要性。有效的诊断涉及认识到躯体症状和患者心理反应的重要性,结构化临床访谈和自我报告问卷等工具发挥着关键作用。管理策略包括心理治疗干预,如认知行为疗法(CBT)、药物治疗和生活方式改变,所有这些都根据患者的需求进行调整。沟通策略在验证患者经历的同时解决潜在的精神问题方面至关重要。积极倾听、生物心理社会框架和反馈法等技巧有助于建立信任并提高治疗依从性。文化考量和使用口译员可加强与不同患者群体的沟通。针对医疗保健提供者的培训计划进一步提高了管理躯体症状障碍的能力。这种综合方法旨在通过协作护理、有效沟通和全面治疗计划来应对躯体症状障碍的多面性,从而改善患者的治疗效果。

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