躯体症状障碍共病做作性障碍的访谈与诊治

Interview and treatment of somatic symptom disorder comorbidity factitious disorder

33岁女咨客在无重大疾病的情况下突发头昏、心慌、气短、呕吐等,多次就诊疗效欠佳。咨客及家属均否认睡眠差、反复清洁、易焦虑担心,访谈中反复诉多种躯体不适。经多次澄清得到真实病史后,总结出她因轻微狐臭而形成的关注本体感觉的固有模式,并在无意识中以卧病在床获取丈夫陪伴,遂诊断为躯体症状障碍共病做作性障碍,给予生物-心理-社会的综合干预。

A thirty - three year old female patient had sudden onset of dizziness,palpitation,shortness of breath and vomiting without any major illness. She experienced no significant improvement after taking a variety of drug treatments. In addition to sleep disturbance, compulsive cleaning and anxiety traits were declined by her and her family. She complained about a series of somatic symptoms repeatedly in the interview. The doctor identified her behavioral pattern after clarifying her true medical history - because of mild body odor, she continuously focused on somatic sensations and unconsciously felt ill while in bed with her husband. She was diagnosed with somatic symptom disorder and factitious disorder. A bio - psycho - social intervention was given as an intervention.