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Survey and Research for Mechanisms of Somatization of General Out-patients

普通门诊患者躯体化机制的调查与研究

基本信息

批准号：
08671097
负责人：
NAKAMURA Michihiko
金额：
$ 0.32万
依托单位：
Kyoto Prefectural University of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1997
项目状态：
已结题

项目摘要

Recent increments of senile population and medical information have enhanced anxiety and attention for own somatic conditions, resulting in vicious circles converting psychosocial stressors into somatic problems. The convertion or somatization produces lots of the patients with "medically untreatable somatic conditions", and brings about medico-economical problems with frequent examinations and excessive pharmacotherapy. Thus we investigated social, familiar and psychological factors behind the somatization.Two hundreds and forty-nine out-patients, visiting a clinic of either internal medicine psychosomatic medicine or psychiatry, answered the questionnaire of socio-psychological factors and selected the present symptoms among the somatization symptom list. The doctor in charge judged predominance of psychological and somatic effects on each symptom and the patients were classified into 4 groups of "No Sympton", "Psychological Predominance", "Somatic Predominance" and "Mixed Effects".The main results were as follows : (1)the patients with "Psychological Predominance" briefly called somatized patients were 37% of the total patients and the sex ratio of male vs. female was 1 : 3.6. The incidence was the highest (74%) in the psychiatric clinic but 12% of the internal patients were somatized. (2)Somatization symptoms could be determined within one month evaluation. (3)The somatized patients showed the following tendencies : they had grown up in the extended families who were sickly and hated mental problems, they led the school life where they had been enthusiastic about sports but indifferent to friendship and health and delayd in physical development, and now they had few pleasures and friends, were indifferent to exercises and healthy circumstances, and used some tranquilizers and hypnotics almost daily. They showed characteristics such as perfectionism, apprehensions and loneliness, and had some hypochondrical ideations.

近年来，老年人口和医疗信息的增加增加了人们对自身躯体状况的焦虑和关注，导致社会心理压力源转化为躯体问题的恶性循环。这种转化或躯体化产生了大量“医学上无法治疗的躯体疾病”的患者，并带来了频繁检查和过度药物治疗的医疗经济问题。因此，我们调查了躯体化背后的社会、熟悉和心理因素。20049名内科、心身医学或精神科门诊的门诊患者回答了社会心理因素问卷，并从躯体化症状列表中选择了当前症状。主治医生对每种症状判断心理和躯体效应的主导性，将患者分为“无症状”、“心理主导”、“躯体主导”和“混合效应”4组。主要结果如下：（1）“心理主导”（简称躯体化）患者占总患者的37%，男女性别比为1： 3.6.精神科诊所的发病率最高（74%），但内部患者也有12%出现躯体化。 (2)1个月评估即可确定躯体化症状。 (3)躯体化患者表现出以下倾向：他们生长在多病、讨厌精神问题的大家庭中，过着热衷体育而淡漠友谊和健康、身体发育迟缓的学校生活，现在他们几乎没有乐趣和朋友，漠视锻炼和健康环境，几乎每天都使用一些镇静剂和催眠药。他们表现出完美主义、忧虑、孤独等特征，并有一些疑病症的想法。