Greene J W, Walker L S
Division of College Health and Young Adult Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Pediatr Clin North Am. 1997 Dec;44(6):1557-72. doi: 10.1016/s0031-3955(05)70574-5.
Psychosomatic problems are common in adolescents, and stress frequently plays a role in their development and maintenance. Armed with an understanding of the stressors experienced by adolescents, the individual's vulnerabilities and competencies and their level of social support, the physician can systematically assess each of these factors. Once the assessment is complete, a management plan can be formulated to address the particular psychosomatic problem. Symptom relief, stress reduction, and promotion of competence are important interventions that can be initiated by the primary care physician. When referrals are made for counseling and other stress management techniques, the primary care physician should maintain contact with the patient and family and remain an integral part of the management team. Incorporating brief discussions about the potential role of stress in health and illness into anticipatory guidance sessions may also help prevent the development of psychosomatic problems in adolescents.
心身问题在青少年中很常见，压力常常在其产生和持续存在过程中起作用。了解青少年所经历的压力源、个体的脆弱性和能力以及他们的社会支持水平后，医生可以系统地评估这些因素。评估完成后，即可制定管理计划来解决特定的心身问题。缓解症状、减轻压力和提升能力是初级保健医生可以开展的重要干预措施。当转诊进行咨询和采用其他压力管理技巧时，初级保健医生应与患者及其家人保持联系，并仍是管理团队的重要组成部分。在预期指导环节中纳入关于压力在健康和疾病中潜在作用的简短讨论，也可能有助于预防青少年心身问题的发生。
