Rief W, Heuser J, Mayrhuber E, Stelzer I, Hiller W, Fichter M M
Roseneck Hospital, Center for Behavioral Medicine, Prien a. Ch., Germany.
J Nerv Ment Dis. 1996 Nov;184(11):680-7. doi: 10.1097/00005053-199611000-00005.
This study evaluated the concordance among different approaches to diagnose patients with multiple somatoform symptoms. Inpatients (N = 108) of a center for behavioral medicine were diagnosed using a structured clinical interview. Somatization disorder according to DSM-IV and ICD-10 was as rare as somatization disorder according to DSM-III-R. The overlap between the criteria of DSM and ICD for somatization disorder was lower than that between DSM-III-R and DSM-IV. Somatoform autonomic dysfunction, a diagnostic category proposed by ICD-10, included fewer patients diagnosed with somatization disorder than the criteria of Escobar and colleagues for abridged somatization disorder (SSI-4/6: this Journal 177:140-146, 1989). Therefore, the Escobar criteria may be a common link between ICD-10 and DSM-IV. Although the original Escobar criteria were built upon the symptom list of DSM-III-R somatization disorder, SSI-3/5 is an empirically derived equivalent according to DSM-IV in our study (a minimum of 3 symptoms for men or 5 symptoms for women out of the list of 33 somatization symptoms according to DSM-IV).
本研究评估了诊断具有多种躯体形式症状患者的不同方法之间的一致性。对一家行为医学中心的108名住院患者采用结构化临床访谈进行诊断。根据《精神疾病诊断与统计手册》第四版（DSM-IV）和《国际疾病分类》第十版（ICD-10）诊断的躯体化障碍与根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）诊断的躯体化障碍一样罕见。DSM和ICD中躯体化障碍标准之间的重叠低于DSM-III-R和DSM-IV之间的重叠。ICD-10提出的诊断类别“躯体形式自主神经功能紊乱”所纳入的被诊断为躯体化障碍的患者少于埃斯科瓦尔及其同事提出的简略躯体化障碍标准（SSI-4/6：本刊177：140 - 146，1989年）。因此，埃斯科瓦尔标准可能是ICD-10和DSM-IV之间的共同联系。尽管最初的埃斯科瓦尔标准基于DSM-III-R躯体化障碍的症状列表构建，但在我们的研究中，根据DSM-IV，SSI-3/5是一个基于经验得出的等效标准（根据DSM-IV的33种躯体化症状列表，男性至少有3种症状，女性至少有5种症状）。
