Singh B S
Department of Psychiatry, the University of Melbourne, VIC.
Med J Aust. 1998 Jun 1;168(11):572-7.
The management of somatoform disorders is a confusing and difficult area. There are many iatrogenic complications, including unnecessary and repetitive investigations and surgery, drug dependence and "doctor shopping". Somatisation is a world wide phenomenon and a common presentation of psychological distress. Three main groups of patients are encountered in general practice: those with high levels of somatic symptoms, those with illness fear, and those with somatic presentations of other psychiatric illnesses. Management is straightforward for the acute cases and consists of trying to get the patient to accept a link between the psychosocial conflicts and the symptoms. Management is very difficult for chronic cases, where care, not cure, is the goal, as is an attempt to limit harm to the patient and limit the cost to the health system.
躯体形式障碍的管理是一个令人困惑且棘手的领域。存在许多医源性并发症，包括不必要的重复性检查与手术、药物依赖以及“反复就医”。躯体化是一种全球现象，是心理困扰的常见表现形式。在全科医疗中会遇到三类主要患者：躯体症状严重的患者、害怕患病的患者以及患有其他精神疾病且有躯体表现的患者。急性病例的管理较为直接，包括努力让患者接受心理社会冲突与症状之间的关联。对于慢性病患者，管理非常困难，此时目标是护理而非治愈，同时要努力限制对患者的伤害以及对卫生系统造成的成本。
