Garcia-Campayo J, Sanz-Carrillo C, Yoldi-Elcid A, Lopez-Aylon R, Monton C
Unidad de Trastornos Somatomorfos, Hospital Miguel Servet, Zaragoza, Spain.
Aust N Z J Psychiatry. 1998 Aug;32(4):528-33. doi: 10.3109/00048679809068327.
The aim of this paper is to assess the attitudes of Spanish general practitioners towards somatisers and the degree of involvement that family doctors are ready to adopt in the care of these patients.
A postal questionnaire on attitudes was sent to a representative sample (n = 135) of general practitioners from two health districts of the region of Aragon. Seventy (51.8%) of them returned usable questionnaires.
Most of the general practitioners were interested in the treatment of somatisers and considered that they should be treated at primary care level. However, when specific treatment tasks were proposed, they only accepted to act as a filter to specialised care and to care for patients with chronic functional syndromes. Additionally, they refuse to detect presenting somatisers, to prescribe psychotropic drugs or offer any psychological approach, and to avoid reinforcing abnormal illness behaviour in these patients and their families. These findings can be explained because the main emotions somatisers produce in doctors are frustration and anger.
Family doctors need a lot more help, education and support in the management of somatisers, and psychiatrists need to provide it. Any management program for the treatment of somatisers in primary care should include methods to modify general practitioners' attitudes towards these patients.
本文旨在评估西班牙全科医生对躯体化障碍患者的态度，以及家庭医生愿意参与这些患者护理的程度。
向阿拉贡地区两个卫生区的全科医生代表性样本（n = 135）发送了一份关于态度的邮政问卷。其中70人（51.8%）返回了可用问卷。
大多数全科医生对躯体化障碍患者的治疗感兴趣，并认为他们应在初级保健层面接受治疗。然而，当提出具体治疗任务时，他们只接受作为专科护理的筛选者，并照顾患有慢性功能综合征的患者。此外，他们拒绝识别现患的躯体化障碍患者、开具精神药物或提供任何心理治疗方法，并避免强化这些患者及其家人的异常疾病行为。这些发现可以解释为，躯体化障碍患者在医生身上引发的主要情绪是沮丧和愤怒。
家庭医生在躯体化障碍患者的管理方面需要更多的帮助、教育和支持，而精神科医生需要提供这些。任何初级保健中躯体化障碍患者的治疗管理计划都应包括改变全科医生对这些患者态度的方法。
