Depression, pain, and somatoform disorders
Depression, pain, and somatoform disorders
复制标题
DOI：
10.1097/01.yco.0000189880.11059.8d
复制
发表时间：
2006-01-01
影响因子：
6.9
通讯作者：
Löwe, B
中科院分区：
文献类型：
--
作者：
Henningsen, P;Löwe, B
综述的目的抑郁症和躯体症状的频繁并存对参与制定分类的临床医生、研究人员和专家构成了持续的挑战。在这篇综述中，我们提出了最近发表的文献方面的流行病学，分类和治疗在这一重要的重叠area.Recent调查结果从众多的论文每年发表的共同发生的不同的疼痛条件和抑郁症，颞下颌关节功能障碍站出来，今年的纯粹数量;它可以被视为一个典范案例，说明有必要在生物和心理社会层面进行有区别的高质量评估。有一个普遍的趋势是将诊断分类的实用性与有效性分开，这加强了分类方法，有助于将抑郁症，疼痛和其他躯体症状的定期重叠视为规则而不是例外。纳入认知变量，如因果归因，应有助于区分重叠病例中的临床相关亚型。“躯体形式障碍”这一类别的分类前景多少有些疑问，但改革似乎比废除更有成效。精神药理学提供了相当激烈的重叠领域最近的报道，与新的双肾上腺素能去甲肾上腺素能再摄取抑制剂提供一些promise.Summary治疗抑郁症，疼痛和其他躯体症状的重叠作为规则，而不是例外是必要的充分的病因学研究以及诊断和治疗，一维的分类和治疗方法几乎肯定是不够的。
Purpose of review The frequent co-occurrence of depression and somatic symptoms poses a continuing challenge to clinicians, researchers and experts involved in drawing up classifications. In this review we present recently published literature on aspects of epidemiology, classification and treatment in this important overlap area.Recent findings From the multitude of papers published annually on the co-occurrence of different pain conditions and depression, temporomandibular dysfunction stands out this year by sheer quantity; it can be seen as a model case of the necessity for differentiated high-quality assessments on the biological as well as the psychosocial level. There is a general move to separate utility of diagnostic classifications from their validity, and this strengthens classificatory approaches that help to view the regular overlap of depression, pain and other somatic symptoms as the rule rather than the exception. The incorporation of cognitive variables like causal attributions should help to distinguish clinically relevant subtypes among overlap cases. The classificatory future of the category of 'somatoform disorders' is somewhat in doubt, but reforms seem to be more productive than abolishment. Psychopharmacology provides rather intense recent coverage of the overlap field, with newer dual serotonergic-noradrenergic reuptake inhibitors offering some promise.Summary Treating the overlap of depression, pain and other somatic symptoms as the rule rather than the exception is necessary for adequate aetiological research as well as for diagnosis and treatment, with one-dimensional classificatory and treatment approaches almost certainly being insufficient.