综合医院躯体形式障碍临床特点的初步研究

Perliminary Investigation on Clinical Features of Somatoform Disorders in General Hospital

目的：了解综合医院门诊病人中符合ＩＣＤ－１０躯体形式障碍的比率及其临床症状特点。方法：采用躯体形式障碍筛选表和躯体形式障碍评定表检查内科和神经科门诊病人。结果：共筛查了３３４６位综合医院的门诊病人，ＩＣＤ－１０躯体形式障碍的估计比率为１８２％。躯体形式障碍各亚型之间重叠较多。１３５例患者在过去一年平均就医１３１次；经过治疗６０％的自感无变化或恶化。躯体化障碍患者的症状中以“对医生的诊断和治疗不信任”最为突出。结论：躯体形式障碍在综合医院内科、神经科门诊有较高的比率。其就医次数较多而治疗效果较差。

Objective:to investigate the clinical features and incidence of somatoform disorders(according to ICD 10 criteria)in outpatients of general hospital.Method:outpatients of neurological and internal medicine department were investigated with Screener for Somatoform Disorders(SSD)and Somatoform Disorder Schedule(SDS).Result:3346 outpatients were screened with SSD and 140 patients were evaluated with SDS.The estimated incidence of somatoform disorders in the 3346 outpatients was 18 2%.Overlap in subtype diagnoses was observed.In the past one year,the 135 patients with somatoform disorders went to see doctors 13 1 times on average.However,60% of them complained of no improvement or even worse after treatments.The frequency of symptom groups of somatoform disorders,from the most to the least,was as follows:dissatisfied with the doctors′ diagnosis and treatment,weakness,physiological disturbance(sleep or sexual),pain,gastro intestinal symptoms,vegetative and conversion symptoms.Conclusion:somatoform disorders had a high incidence in outpatient population of general hospital.The patients with somatoform disorders went to see doctors frequently and most of them dissatisfied with the medial service provided.The ICD-10 Criteria for the diagnosis of subtypes of somatoform disorders need further specify.