Escobar J I, Waitzkin H, Silver R C, Gara M, Holman A
Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway 08854-5635, USA.
Psychosom Med. 1998 Jul-Aug;60(4):466-72. doi: 10.1097/00006842-199807000-00012.
We examined the prevalence, correlates, and predictive value of an abbreviated somatization index, based on specific symptom thresholds, in primary care patients using services at a university-affiliated clinic.
We interviewed 1456 patients with a survey instrument that included the Composite International Diagnostic Interview (CIDI) to elicit symptoms and diagnoses of several psychiatric disorders as well as demographic information and a measure of disability. Statistical analyses examined the relationship of abridged somatization with physical functioning and various demographic and diagnostic factors.
About one fifth of this primary care sample met the abridged somatization criteria. "Somatizers," defined according to these criteria, had significantly higher levels of psychiatric comorbidity and disability than "nonsomatizers". Analyses taking into account the number and type of organ/body systems represented by the unexplained symptoms showed that this dimension adds specificity to the prediction of outcomes. Thus, regardless of the total number of medically unexplained symptoms, abridged somatization with unexplained symptoms attributable to four or more organ/body systems showed the strongest association with disability and psychopathology.
Abridged Somatization is a frequent syndrome in primary care that is strongly associated with psychopathology and physical disability. Our research also yielded a new series of abridged somatization subtypes (eg, "discrete" vs. "comorbid" and "simple" vs. "polymorphous") that may effectively separate among various psychopathologies, and may become useful tools for future research with somatizing patients.
我们在一所大学附属医院诊所就诊的初级保健患者中，基于特定症状阈值，研究了简化躯体化指数的患病率、相关因素及预测价值。
我们用一份包含综合国际诊断访谈（CIDI）的调查问卷对1456名患者进行访谈，以引出多种精神障碍的症状和诊断，以及人口统计学信息和残疾测量指标。统计分析检验了简化躯体化与身体功能以及各种人口统计学和诊断因素之间的关系。
该初级保健样本中约五分之一的患者符合简化躯体化标准。根据这些标准定义的“躯体化者”比“非躯体化者”有显著更高的精神共病率和残疾水平。考虑到不明原因症状所涉及的器官/身体系统数量和类型的分析表明，这一维度增加了对结果预测的特异性。因此，无论医学上不明原因症状的总数如何，由四个或更多器官/身体系统引起的不明原因症状的简化躯体化与残疾和精神病理学的关联最强。
简化躯体化是初级保健中常见的综合征，与精神病理学和身体残疾密切相关。我们的研究还产生了一系列新的简化躯体化亚型（例如，“离散型”与“共病型”以及“简单型”与“多形型”），这些亚型可能有效地区分各种精神病理学情况，并可能成为未来对躯体化患者研究的有用工具。
