Lim L E
Institute of Mental Health/Woodbridge Hospital, Singapore.
Singapore Med J. 1994 Oct;35(5):519-22.
Pain is a symptom commonly encountered by the medical profession. After excluding organicity, the possibility of psychogenic mechanisms should be borne in mind. Diagnostic clues in the history and physical examination are outlined. An early referral to the psychiatric services minimises wastage of time and resources but requires skillful handling and sensitivity on the part of the referrer. Patients do not regard themselves as psychologically abnormal and are often resentful and angry when referred for psychiatric evaluation. Principles of management are described with emphasis on establishing an early rapport. Cognitive behavioural methods appear promising but require further evaluation in controlled studies.
疼痛是医疗行业中常见的症状。排除器质性病变后，应考虑心理机制的可能性。本文概述了病史和体格检查中的诊断线索。尽早转介至精神科服务可减少时间和资源的浪费，但这需要转介者具备熟练的技巧和敏感度。患者并不认为自己存在心理异常，当被转介进行精神科评估时，他们往往会感到不满和愤怒。本文描述了管理原则，重点是建立早期的融洽关系。认知行为方法似乎很有前景，但需要在对照研究中进行进一步评估。
