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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients.
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Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients.

机译：身体不适的症状和综合征：978名内部医疗，神经和初级保健患者的探索性研究。

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OBJECTIVE: Physical complaints not attributable to verifiable, conventionally defined diseases, i.e., medically unexplained or functional somatic symptoms, are prevalent in all medical settings, but their classification is contested as numerous overlapping diagnoses and syndrome labels have been introduced. This study aims to determine whether functional somatic symptoms cluster into distinct syndromes and diagnostic entities. METHODS: The 978 consecutively admitted patients from a neurological department (n = 120), a medical department (n = 157), and from primary care (n = 701) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) diagnostic instrument. RESULTS: Patients complained of a median of five functional somatic symptoms; women of six, men of four (p < .0001). No single symptoms stood out as distinctive for patients with multiple symptoms. Principal component factor analysis identified a cardiopulmonary including autonomic (CP), a musculoskeletal (MS), and a gastrointestinal (GI) symptom group explaining 36.9% of the variance. Latent class analysis showed that the symptom groups are likely to materialize in the same patients, suggesting that they are different manifestations of a common latent phenomenon. Inclusion of a group of five additional general, unspecific symptoms in latent class analysis allowed construction of clinical diagnostic criteria for 'bodily distress disorder' dividing patients into three classes: nonbodily distress (n = 589), modest bodily distress (n = 329, prevalence 25.3%, men 20.4%, women 25.6%), and severe bodily distress (n = 60, prevalence 3.3%, men 1.2%, women 4.8%). CONCLUSION: The study suggests that bodily distress disorder as defined here may unite many of the functional somatic syndromes and some somatoform disorder diagnoses. Bodily distress may be triggered by stress rather than being distinct diseases of noncerebral pathology.
机译：目的：不适用于可证实的，传统上定义的疾病（即医学上无法解释的或功能性的躯体症状）的身体不适在所有医疗环境中均很普遍，但由于引入了许多重叠的诊断方法和综合症标签，因此对其分类存在争议。这项研究旨在确定功能性躯体症状是否聚类为不同的综合征和诊断实体。方法：使用神经精神病学临床评估表（SCAN）诊断工具对来自神经科（n = 120），医疗科（n = 157）和基层医疗（n = 701）的978例连续入院的患者进行了访谈。 。结果：患者主诉五种功能性躯体症状的中位数。女性六岁，男性四岁（p <.0001）。对于有多种症状的患者，没有任何一种独特的症状与众不同。主成分因子分析确定了包括自主神经（CP），肌肉骨骼（MS）和胃肠道（GI）症状组的心肺功能，解释了36.9％的差异。潜在类别分析表明，症状组可能在同一患者中出现，表明它们是常见潜在现象的不同表现。在潜在类别分析中包括一组五种其他一般性，非特异性症状，可以构建针对“身体窘迫疾病”的临床诊断标准，将患者分为三类：非身体窘迫（n = 589），中度身体不适（n = 329，患病率） 25.3％，男性20.4％，女性25.6％）和严重的身体不适（n = 60，患病率3.3％，男性1.2％，女性4.8％）。结论：该研究表明，本文定义的身体窘迫障碍可能将许多功能性躯体综合症和某些躯体形式障碍的诊断结合在一起。身体不适可能是由压力触发的，而不是非脑病理的独特疾病。

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