Tollefson G D, Garvey M J
J Fam Pract. 1983 Jan;16(1):73-7.
A variety of psychologic disorders may present as physical complaints without organic basis. As characterized by Sydenham over 300 years ago, such disorders "mimic all the physical disease to which man is heir." The case here presents the evolution of a conversion disorder (urinary retention) in response to a decision to terminate pregnancy. The predominant disturbance in a conversion disorder is an involuntary loss or alteration in somatic function that is temporally related with an environmental stressor. Conversion, as a defense mechanism, provides primary gain by keeping the conflict from the patient's awareness and secondary gains by generating environmental support and avoidance of undesired activities. Awareness of a patient's current life events, past responses to stress, and support systems is essential in order to recognize and manage this array of physical complaints of functional origin.
多种心理障碍可能表现为无器质性基础的躯体主诉。正如300多年前西德纳姆所描述的，这类障碍“模仿人类所患的所有躯体疾病”。本文病例展示了一例因决定终止妊娠而引发的转换障碍（尿潴留）的发展过程。转换障碍的主要障碍是躯体功能的非自愿丧失或改变，这与环境应激源在时间上相关。转换作为一种防御机制，通过使冲突不被患者意识到而提供原发性获益，并通过获得环境支持和避免不期望的活动而提供继发性获益。了解患者当前的生活事件、过去对压力的反应以及支持系统，对于识别和处理这一系列源于功能性的躯体主诉至关重要。
