Escobar J I
Department of Psychiatry, UMDNJ-Robert Wood Johnson Medical School, Piscataway 08854-5635, USA.
Psychopharmacol Bull. 1996;32(4):589-96.
This article outlines critical issues in the psychiatric assessment of patients presenting with medically unexplained physical symptoms that form the core of the somatoform disorders in current nosologies. The prevalence of these disorders in communities and clinical settings emphasizes that a majority of these patients are primary care service users rather than mental health clients. A brief review of previous studies on the pharmacological management of these syndromes with antidepressants highlights unique features of these disorders that are relevant to the design of double-blind studies. The promising results emerging from some of these studies bring new excitement to the field that may help counter the prevailing therapeutic nihilism, thus attracting new investigators to this area. Finally, several caveats are provided on issues of research design and interpretation for the benefit of those entering this field of research.
本文概述了对表现出医学上无法解释的身体症状的患者进行精神科评估中的关键问题，这些症状是当前疾病分类中躯体形式障碍的核心。这些障碍在社区和临床环境中的患病率表明，这些患者中的大多数是初级保健服务使用者，而非心理健康服务对象。对以往使用抗抑郁药对这些综合征进行药物治疗的研究进行简要回顾，突出了这些障碍的独特特征，这些特征与双盲研究的设计相关。其中一些研究得出的有前景的结果给该领域带来了新的活力，这可能有助于对抗普遍存在的治疗虚无主义，从而吸引新的研究人员进入这一领域。最后，为了使那些进入该研究领域的人受益，针对研究设计和解释问题给出了一些注意事项。
