Saxe G N, Chinman G, Berkowitz R, Hall K, Lieberg G, Schwartz J, van der Kolk B A
Trauma Clinic, Harvard Medical School, Boston, MA.
Am J Psychiatry. 1994 Sep;151(9):1329-34. doi: 10.1176/ajp.151.9.1329.
This study attempted to determine the prevalence of somatic symptoms, somatization disorder, and medical interventions in patients with dissociative disorders.
Fourteen psychiatric inpatients with a DSM-III dissociative disorder were matched for age and gender with a comparison group of inpatients who reported few dissociative symptoms. All subjects were interviewed in a blind manner with the Dissociative Disorders Interview Schedule (this semistructured interview schedule includes a section on somatization disorder), and their hospital charts were reviewed to determine somatic symptoms and medical histories.
Sixty-four percent of the patients with dissociative disorders met DSM-III criteria for somatization disorder and reported an average of 12.4 somatic symptoms. None of the comparison patients met DSM-III criteria for somatization disorder, and these patients reported an average of 3.1 somatic symptoms. These differences between the two groups were significant. Significant differences were also found in the number of medical hospitalizations and consultations between the two groups. A significant correlation was found between the degree of dissociation and degree of somatization in patients with dissociative disorders.
The authors conclude that somatization disorder is a frequent and serious comorbid disorder among patients with dissociative disorders.
本研究试图确定分离性障碍患者中躯体症状、躯体化障碍及医学干预的患病率。
14名符合《精神疾病诊断与统计手册》第三版（DSM-III）分离性障碍诊断标准的精神科住院患者，在年龄和性别上与报告很少有分离症状的住院患者对照组进行匹配。所有受试者均采用盲法接受分离性障碍访谈量表（该半结构化访谈量表包括一个关于躯体化障碍的部分）访谈，并查阅其病历以确定躯体症状和病史。
64%的分离性障碍患者符合DSM-III躯体化障碍诊断标准，平均报告12.4种躯体症状。对照组患者均不符合DSM-III躯体化障碍诊断标准，这些患者平均报告3.1种躯体症状。两组之间的这些差异具有显著性。两组在住院次数和会诊次数上也存在显著差异。在分离性障碍患者中，分离程度与躯体化程度之间存在显著相关性。
作者得出结论，躯体化障碍在分离性障碍患者中是一种常见且严重的共病障碍。
