Somatic symptoms in depression.
Somatic symptoms in depression.
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DOI：
10.31887/dcns.2006.8.2/hpkapfhammer
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发表时间：
2006
影响因子：
8.3
通讯作者：
Kapfhammer HP
中科院分区：
文献类型：
--
作者：
Kapfhammer HP
疼痛和非疼痛的躯体症状本质上都是抑郁情绪临床状态的特征。到目前为止，精神疾病诊断和统计手册第四版文本修订版 (DSM-IVTR) 和 ICD-10 精神和行为障碍分类的官方诊断系统对这一完善的精神病理学知识的认识还不够。临床描述和诊断指南 (ICD-10)。从初级保健服务的角度来看，这种未得到满足的诊断需求是令人遗憾的，因为呈现抑郁症的主要方式是报告躯体症状。然而，这种躯体表现形式极大地导致了初级保健中识别率的低下。将伴有躯体症状的抑郁症与焦虑、躯体形式障碍和医疗状况区分开来可能是诊断上的挑战。当躯体症状，特别是痛苦的身体状况，伴随着已经令人衰弱的抑郁症精神和行为症状时，病程可能会更加严重，意味着早期复发、慢性自杀或因其他自然原因导致死亡的风险更高，经济负担显着增加，功能状态可能受到严重阻碍，与健康相关的生活质量可能急剧下降。抑郁症躯体症状的神经生物学基础可能会指导更有希望的治疗方法。
Both painful and nonpainful somatic symptoms essentially characterize clinical states of depressive mood. So far, this well-established psychopathological knowledge has been appreciated only insufficiently by the official diagnostic sys-terms of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IVTR) and the ICD-10 Classification of Mental and Behavioral Disorders. Clinical Descriptions and Diagnostic Guidelines (ICD-10). From a perspective of primary care services, this unmet diagnostic need is deplorable, as the main mode of presenting a depression is by reporting somatic symptoms. This somatic form of presentation, however, significantly contributes to low rates of recognition in primary care. A diagnostic challenge may be seen in the differentiation of a depression with prevailing somatic symptoms from anxiety, somatoform disorders, and medical conditions. When somatic symptoms, particularly painful physical conditions, accompany the already debilitating psychiatric and behavioral symptoms of depression, the course of the illness may be more severe, implying a higher risk of early relapse, chronicity suicide, or mortality due to other natural causes, the economic burden increases considerably, the functional status may be hampered heavily, and health-related quality of life may be lowered dramatically. The neurobiological underpinnings of somatic symptoms in depression may guide more promising treatment approaches.