症状与体征：躯体疾病还是患病行为？
Symptoms and signs: physical disease or illness behaviour?
作者信息
Waddell G, Bircher M, Finlayson D, Main C J
出版信息
Br Med J (Clin Res Ed). 1984 Sep 22;289(6447):739-41. doi: 10.1136/bmj.289.6447.739.
Abstract
The amount of treatment received by 380 patients with backache was found to have been influenced more by their distress and illness behaviour than by the actual physical disease. Patients showing a large amount of inappropriate illness behaviour had received significantly more treatment (p less than 0.001). The symptoms and signs of illness behaviour need to be clearly distinguished from those of physical disease, and better assessment of illness behaviour is essential if everyday clinical practice is to fulfil the ideal of treating patients as well as diseases.
摘要
研究发现，380名背痛患者接受治疗的量更多地受到其痛苦和疾病行为的影响，而非实际身体疾病的影响。表现出大量不适当疾病行为的患者接受的治疗显著更多（p小于0.001）。疾病行为的症状和体征需要与身体疾病的症状和体征明确区分，并且如果日常临床实践要实现既治疗患者又治疗疾病的理想，对疾病行为进行更好的评估至关重要。
相似文献
1
Symptoms and signs: physical disease or illness behaviour?症状与体征：躯体疾病还是患病行为？
Br Med J (Clin Res Ed). 1984 Sep 22;289(6447):739-41. doi: 10.1136/bmj.289.6447.739.
2
Lumbar traction therapy; elimination of physical factors that prevent lumbar stretch.
J Am Med Assoc. 1955 Oct 8;159(6):549-50. doi: 10.1001/jama.1955.02960230013005.
3
Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study.腰椎间盘突出症的手术治疗与保守治疗：一项前瞻性队列研究。
BMJ Open. 2016 Dec 21;6(12):e012938. doi: 10.1136/bmjopen-2016-012938.
4
5
Editorial: Backache and sciatica: a new breakthrough or a new controversy?社论：背痛与坐骨神经痛：新突破还是新争议？
Med J Aust. 1974 Jan 5;1(1):3. doi: 10.5694/j.1326-5377.1974.tb93086.x.
6
Chiropractic: a model of incorporating the illness behavior model in the management of low back pain patients.整脊疗法：一种将疾病行为模型纳入腰痛患者管理的模式。
J Manipulative Physiol Ther. 1991 Jul-Aug;14(6):379-89.
7
Observation of overt pain behaviour by physicians during routine clinical examination of patients with low back pain.医生在对腰痛患者进行常规临床检查时对明显疼痛行为的观察。
J Psychosom Res. 1992 Jan;36(1):77-87. doi: 10.1016/0022-3999(92)90116-j.
8
The management of back pain.背痛的管理
Proc R Soc Med. 1974 Jun;67(6 Pt 1):496-8. doi: 10.1177/00359157740676P131.
9
[Lumbago, sciatica and brachialgia; psychological treatment and vertebral disks].[腰痛、坐骨神经痛和臂丛神经痛；心理治疗与椎间盘]
Dtsch Med J. 1953 Mar 15;4(5-6):114-7; concl.
10
Indications, technique and results of caudal epidural injection for lumbar disc retropulsion.腰椎间盘后突尾侧硬膜外注射的适应症、技术及结果
Postgrad Med J. 1977 Jan;53(615):1-6. doi: 10.1136/pgmj.53.615.1.
引用本文的文献
1
Systematic review and tools appraisal of prognostic factors of return to work in workers on sick leave due to musculoskeletal and common mental disorders.对因肌肉骨骼疾病和常见精神障碍而休病假的工人恢复工作预后因素的系统评价和工具评估
PLoS One. 2024 Jul 17;19(7):e0307284. doi: 10.1371/journal.pone.0307284. eCollection 2024.
2
Pain and the Non-Pharmacological Management of Pain in People with Parkinson's Disease.帕金森病患者的疼痛与非药物性疼痛管理。
J Parkinsons Dis. 2024;14(s1):S65-S80. doi: 10.3233/JPD-230227.
3
Abnormal Pain Response After a Compensable Shoulder Injury.可补偿性肩部损伤后的异常疼痛反应
Orthop J Sports Med. 2017 Nov 20;5(11):2325967117739851. doi: 10.1177/2325967117739851. eCollection 2017 Nov.
4
Diagnosis and management of atypical and persistent anterolateral knee pain in a 16-year-old triathlete: an iterative process.一名16岁三项全能运动员非典型持续性膝前外侧疼痛的诊断与管理：一个反复的过程
Int J Sports Phys Ther. 2013 Dec;8(6):849-61.
5
Chronic pain and vocational rehabilitation: A multifactorial analysis of symptoms, signs, and psycho-socio-demographics.慢性疼痛与职业康复：症状、体征及心理-社会-人口学的多因素分析。
J Occup Rehabil. 1992 Jun;2(2):53-66. doi: 10.1007/BF01079012.
6
Overdiagnosis and overtreatment of low back pain: Long-term effects.下背痛的过度诊断与过度治疗：长期影响。
J Occup Rehabil. 1991 Dec;1(4):303-12. doi: 10.1007/BF01073695.
7
Predictive model to determine cost/benefit of early detection and intervention in occupational low back pain.预测模型，用于确定职业性下腰痛早期检测和干预的成本效益。
J Occup Rehabil. 1991 Jun;1(2):113-31. doi: 10.1007/BF01073382.
8
Symptom Magnification Syndrome Structured Interview: Rationale and procedure.症状夸大综合征结构式访谈：原理与程序。
J Occup Rehabil. 1991 Mar;1(1):43-56. doi: 10.1007/BF01073279.
9
Screening for patients at risk of developing chronic incapacity.筛查有发展为慢性失能风险的患者。
J Occup Rehabil. 1995 Dec;5(4):207-17. doi: 10.1007/BF02109986.
10
Ineffective chronic illness behaviour in a patient with long-term non-psychotic psychiatric illness.一名患有长期非精神病性精神疾病患者的无效慢性病行为。
BMJ Case Rep. 2010 Nov 29;2010:bcr0220102739. doi: 10.1136/bcr.02.2010.2739.
本文引用的文献
1
Effect of tetracycline on leucocyte ascorbic Acid levels.四环素对白细胞中维生素C水平的影响。
Br Med J. 1972 Jan 22;1(5794):214-5. doi: 10.1136/bmj.1.5794.214.
2
A SELF-RATING DEPRESSION SCALE.一份自评抑郁量表。
Arch Gen Psychiatry. 1965 Jan;12:63-70. doi: 10.1001/archpsyc.1965.01720310065008.
3
Nonorganic physical signs in low-back pain.下背痛中的非器质性体征。
Spine (Phila Pa 1976). 1980 Mar-Apr;5(2):117-25. doi: 10.1097/00007632-198003000-00005.
4
Chronic low-back pain, psychologic distress, and illness behavior.慢性腰痛、心理困扰与疾病行为。
Spine (Phila Pa 1976). 1984 Mar;9(2):209-13. doi: 10.1097/00007632-198403000-00013.
5
Assessment of severity in low-back disorders.下背部疾病严重程度的评估。
Spine (Phila Pa 1976). 1984 Mar;9(2):204-8. doi: 10.1097/00007632-198403000-00012.
6
The Modified Somatic Perception Questionnaire (MSPQ).改良躯体感知问卷（MSPQ）。
J Psychosom Res. 1983;27(6):503-14. doi: 10.1016/0022-3999(83)90040-5.
7
An approach to backache.背痛的治疗方法。
Br J Hosp Med. 1982 Sep;28(3):187, 190-1, 193-4, passim.
8
Normality and reliability in the clinical assessment of backache.背痛临床评估中的正常性与可靠性。
Br Med J (Clin Res Ed). 1982 May 22;284(6328):1519-23. doi: 10.1136/bmj.284.6328.1519.
9
The lumbar disc herniation. A computer-aided analysis of 2,504 operations.腰椎间盘突出症。对2504例手术的计算机辅助分析。
Acta Orthop Scand Suppl. 1972;142:1-95. doi: 10.3109/ort.1972.43.suppl-142.01.
10
A general classification of abnormal illness behaviours.
Br J Med Psychol. 1978 Jun;51(2):131-7. doi: 10.1111/j.2044-8341.1978.tb02457.x.
Zotero 插件