躯体化障碍患者临床特征的调查

A survey on clinical features of somatization disorder

目的了解躯体化障碍患者临床特征。方法对2006年9月至2008年8月诊治的79例躯体化障碍患者（诊断符合《中国精神障碍分类与诊断标准（第三版）》标准），采用自编躯体症状清单、症状自评量表、汉密尔顿焦虑量表和汉密尔顿抑郁量表进行评估。结果躯体化障碍涉及的系统2—6个，平均（4．2±0．9）个，症状共62项，平均（12．4±6．6）项。最常见为皮肤症状、神经系统症状、胃肠道症状、呼吸循环系统症状，多伴抑郁、焦虑、敌对情绪，躯体性症状数目、躯体性症状总分与汉密尔顿焦虑量表总分、躯体焦虑因子分、精神焦虑因子分均呈正相关（P〈0．01），与汉密尔顿抑郁量表总分无相关（P〉0．05）。结论躯体化障碍涉及的系统多，症状复杂，易被误诊，多伴抑郁、焦虑情绪，症状数目、程度与焦虑情绪呈正相关。

Objective To investigate clinical features of somatization disorder. Methods Seventynine patients with somatization disorder （SD） , diagnosed based on the Chinese Classification and Diagnostic Criteria of Mental Disorders, version 3 （ CCMD-3 ） during September 2006 to August 2008, were selected and assessed by self-edited somatic symptom list （SSSL）, symptom checklist-90 （SCL-90）, Hamilton anxiety scale （HAMA） and Hamihon depression scale （HAMD）. Results Sixty-two symptoms in two to six systems were involved in SDs, with a mean and standard deviation of 12. 4 ± 6. 6 symptoms in 4. 2 ± 0. 9 systems. The skin, nervous system, gastrointestinal system, respiratory and circulatory systems were the most involved in those symptoms. Depression, anxiety and hostile mood, number and total score of somatic symptoms all correlated positively with the total scores of HAMA and scores of somatic anxiety and mental anxiety （P 〈 0. 01 ）, but not with the total score of HAMD （P 〉 0. 05）. Conclusions Multiple systems were involved in SD, usually with complicated symptoms including depression and anxiety, which was prone to inappropriate medical diagnoses. Number and severity of somatic symptoms positively correlated with severity of anxious symptoms.