谈中国人躯体化现象及躯体样障碍

Somatization and somatoform disorder in Chinese society

“躯体化现象”是一个颇为复杂的概念。西方学者往往将此误指为中国(及其他亚裔)病人不善表达情绪的结果。本文除阐释“躯体化现象”的不同意义外,并集中探讨影响着这一现象的社会、经济因素。我们更建议了一个名为“躯体兼情绪障碍”的诊断项目,使“神经衰弱”归属于其下,从而代替现有的“躯体化”类诊断。为了提高医疗效益与素质,我们也建议对治疗方法进行严格研究,以及推行一个平等的医疗政策。

Somatization is a complex concept that is often inaccurately used by Western researchers to refer to Chinese and other Asian patients' inability to express themselves emotionally. In this paper, we review the different meanings of somatization, and argue that socioeconomic factors impacting on both patients and care-givers have a critical influence on this phenomenon, in Asian as well as Western settings. We also propose the establishment of a category of somatodysphoric disorder in future nosologi-cal systems, and recommand that the somatoform-categories should only be used when neurasthenia (as a secial form of somatodysphoric disorder) cannot be diagnosed. The need for controlled treatment studies as well as health policy that reduces social inequity is emphasized.