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伴有功能性躯体症状的自闭症患者高质量护理面临的挑战:基于病例的叙事综述与探索性生物心理社会模型

Challenges to high-quality care in autism with functional somatic symptoms: A case-inspired narrative review and exploratory biopsychosocial model.

作者信息

Zotti Lilian, Esposito Dario, Di Iorio Giorgia, Covuccia Marilina, Orecchio Silvia, Ferrara Mauro, Conte Giulia

机构信息

Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Italy.

Child and Adolescent Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University of Rome, Italy.

出版信息

Clin Child Psychol Psychiatry. 2025 Jul;30(3):562-587. doi: 10.1177/13591045251343692. Epub 2025 May 16.

Abstract

BackgroundChildren and adolescents with autism spectrum disorder (ASD) frequently experience functional somatic symptoms (FSS), although the underlying causes often remain unclear. Various biological and psychological factors, both individual and within families, such as alexithymia or health anxiety, can intensify these symptoms, sometimes resulting in excessive and unnecessary medical interventions.MethodsA narrative review of the literature was conducted, alongside the presentation of a case report involving a 13-year-old boy with ASD. The case illustrates how personal and familial factors can influence the presentation of FSS and the risks of inappropriate treatment.DiscussionThe findings suggest that psychological and familial factors play a significant role in the manifestation of FSS in ASD. These factors can increase the risk of unnecessary medicalization, as they often lead to misinterpretation of symptoms by caregivers and healthcare providers. The case report further underscores how the interaction of personal and familial dynamics can complicate the management of FSS. A comprehensive biopsychosocial approach that addresses both the individual and the family is crucial for managing FSS in ASD. Future research should focus on developing targeted interventions that address these psychological and familial influences to enhance the quality of care and reduce unnecessary and potentially harmful healthcare utilization in ASD.

摘要

背景

患有自闭症谱系障碍(ASD)的儿童和青少年经常出现功能性躯体症状(FSS),但其潜在原因往往仍不明确。各种生物和心理因素,包括个体因素及家庭因素,如述情障碍或健康焦虑,都可能加剧这些症状,有时会导致过度且不必要的医疗干预。

方法

对文献进行叙述性综述,并呈现一例涉及一名13岁ASD男孩的病例报告。该病例说明了个人和家庭因素如何影响FSS的表现以及不适当治疗的风险。

讨论

研究结果表明,心理和家庭因素在ASD中FSS的表现中起着重要作用。这些因素会增加不必要医疗化的风险,因为它们常常导致照顾者和医疗服务提供者对症状的误解。该病例报告进一步强调了个人和家庭动态的相互作用如何使FSS的管理变得复杂。一种兼顾个体和家庭的综合生物心理社会方法对于管理ASD中的FSS至关重要。未来的研究应侧重于开发有针对性的干预措施,以应对这些心理和家庭影响,从而提高护理质量,减少ASD中不必要的、潜在有害的医疗利用。

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