Volume 20 Issue 3
Mar.  2022
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FENG Xian, YAO Yuan-long, HUANG Wen-bo, WANG Liu-yi. Identification and management of somatic symptoms disorder by general practitioners[J]. Chinese Journal of General Practice, 2022, 20(3): 357-359. doi: 10.16766/j.cnki.issn.1674-4152.002352
Citation: FENG Xian, YAO Yuan-long, HUANG Wen-bo, WANG Liu-yi. Identification and management of somatic symptoms disorder by general practitioners[J]. Chinese Journal of General Practice, 2022, 20(3): 357-359. doi: 10.16766/j.cnki.issn.1674-4152.002352

Identification and management of somatic symptoms disorder by general practitioners

doi: 10.16766/j.cnki.issn.1674-4152.002352
Funds:

 201602202

  • Received Date: 2021-08-12
    Available Online: 2022-08-13
  • More and more patients with somatic symptoms disorder (SSD) with physical discomfort as the chief complaint are treated in general clinic. These patients are plagued by painful somatic symptoms for years and are treated in various specialties or general clinic of general hospitals, but they cannot be correctly identified and dealt with. In most western countries, general practitioners provide most mental health services. General practitioners have an important role to play in the identification of such diseases, and earlier detection and management can reduce the burden on patients and clinicians. Therefore, it is a challenge for general practitioners to correctly identify patients with psychological disorders who complain of physical discomfort and provide them with continuous, comprehensive and individualized management. General practitioners as "gatekeeper" of most of the patients health, how to use "biological-psychological-social" comprehensive model to help somatization disorder to understand the importance of its symptoms, and through their own learning knowledge about mental illness, correct selection and use of all kinds of tools, such as psychological scale to improve the recognition of SSD patients, in view of the patient's discomfort to take effective relief measures, and in the process of medication treatment, auxiliary necessary psychological treatment, etc. With the deepening of China's medical reform system and the implementation of the hierarchical diagnosis and treatment system, general practitioners and psychiatrists work together to improve the diagnosis and treatment effect of SSD. Therefore, this article from the body symptoms of disorders of the epidemiology and the present situation, the etiology, clinical manifestation and diagnosis, general practitioners in the face of such patients clinical thinking, to do a review, so as to improve the identify of general practitioners' right is complained of mental disorder patients with body discomfort, and provide a continuous, comprehensive, individualized management.

     

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  • [1]
    陆林. 沈渔邨精神病学[M]. 6版. 北京: 人民卫生出版社, 2018: 529-532.

    LU L. Shen Yucun's Psychiatry[M]. 6th edition. Beijing: People's Medical Publishing House, 2018: 529-532.
    [2]
    欧红霞. 躯体症状及相关障碍诊断命名历史变迁和研究进展[J]. 中华精神科杂志, 2021, 54(1): 66-70.

    OU H X. The historical changes and research progress of somatic symptom and related disorders[J]. Chinese Journal of Psychiatry, 2021, 54(1): 66-70.
    [3]
    XIONG N, WEI J, FRITZSCHE K, et al. Psychological and somatic distress in Chinese outpatients at general hospitals: A cross-sectional study[J]. Ann Gen Psychiatry, 2017, 16(10): 35.
    [4]
    PARKER D, BYNG R, DICKENS C, et al. Patients' experiences of seeking help for emotional concerns in primary care: Doctor as drug, detective and collaborator[J]. BMC Fam Pract, 2020, 21(1): 35. doi: 10.1186/s12875-020-01106-z
    [5]
    LAMAHEWA K, BUSZEWICZ M, WALTERS K, et al. Persistent unexplained physical symptoms: A prospective longitudinal cohort study in UK primary care[J]. Br J Gen Pract, 2019, 69(681): e246-e253. doi: 10.3399/bjgp19X701249
    [6]
    CAO J, WEI J, FRITZSCHE K, et al. Prevalence of DSM-5 somatic symptom disorder in Chinese outpatients from general hospital care[J]. Gen Hosp Psychiatry, 2020, 62(32): 63-71.
    [7]
    陈然, 张岚. 躯体症状障碍B标准量表(中文版)在西部综合医院门诊患者中的信度和效度研究[J]. 中华精神科杂志, 2020, 53(5): 419-425. doi: 10.3760/cma.j.cn113661-20200608-00260

    CHEN R, ZHANG L. The reliability and validity of Somatic Symptom Disorder-B Criteria Scale (Chinese Version)in the outpatients of general hospitals in west China[J]. Chinese Journal of Psychiatry, 2020, 53(5): 419-425. doi: 10.3760/cma.j.cn113661-20200608-00260
    [8]
    HENNINGSEN P. Management of somatic symptom disorder[J]. Dialogues Clin Neurosci, 2018, 20(1): 23-31. doi: 10.31887/DCNS.2018.20.1/phenningsen
    [9]
    汪凯, 朱春燕, 陈海波. 综合医院焦虑、抑郁与躯体化症状诊断治疗的专家共识[J]. 中华神经科杂志, 2016, 49(12): 908-917. doi: 10.3760/cma.j.issn.1006-7876.2016.12.002

    WANG K, ZHU C Y, CHEN H B. Expert consensus on the diagnosis and treatment of anxiety, depression and somatization symptoms in general hospitals[J]. Chinese Journal of Neurology, 2016, 49(12): 908-917. doi: 10.3760/cma.j.issn.1006-7876.2016.12.002
    [10]
    刘永珍, 尹静, 武月红, 等. 门诊慢性失眠患者躯体化症状自评量表的临床应用[J]. 脑与神经疾病杂志, 2017, 25(8): 486-489. https://www.cnki.com.cn/Article/CJFDTOTAL-LYSJ201708009.htm

    LIU Y Z, YIN J, WU Y H, et al. Clinical application of self-rating somatization symptoms scale in patients with chronic insomnia in general hospital of Beijing[J]. Journal of Brain and Nervous Diseases, 2017, 25(8): 486-489. https://www.cnki.com.cn/Article/CJFDTOTAL-LYSJ201708009.htm
    [11]
    JIANG M, ZHANG W, SU X, et al. Identifying and measuring the severity of somatic symptom disorder using the Self-reported Somatic Symptom Scale-China (SSS-CN): A research protocol for a diagnostic study[J]. BMJ Open, 2019, 9(9): e024290. doi: 10.1136/bmjopen-2018-024290
    [12]
    ERKIC M, BAILER J, FENSKE S C, et al. Impaired emotion processing and a reduction in trust in patients with somatic symptom disorder[J]. Clin Psychol Psychother, 2018, 25(1): 163-172. doi: 10.1002/cpp.2151
    [13]
    杨程惠, 周波, 周凡, 等. 躯体症状障碍患者疾病认知的质性研究[J]. 中华行为医学与脑科学杂志, 2019, 28(10): 898-902. doi: 10.3760/cma.j.issn.1674-6554.2019.10.007

    YANG C H, ZHOU B, ZHOU F, et al. Illness perception in patients with somatic symptom disorder: A qualitative study[J]. Chinese Journal of Behavioral Medicine and Brain Science, 2019, 28(10): 898-902. doi: 10.3760/cma.j.issn.1674-6554.2019.10.007
    [14]
    姜默琳, 卢伟. 躯体症状障碍的治疗研究进展[J]. 医学综述, 2018, 24(20): 4039-4043. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZS201820016.htm

    JIANG M L, LU W. Research progress in treatment of somatic symptom disorder[J]. Medical Recapitulate, 2018, 24(20): 4039-4043. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZS201820016.htm
    [15]
    林炽甄, 郑义侯. 郑义侯教授从肝论治躯体化障碍经验[J]. 四川中医, 2017, 35(5): 8-10. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201705004.htm

    LIN Z Z, ZHENG Y H. Experience of Professor ZHENG Yihou who treats somatization disorder from liver[J]. Journal of Sichuan of Traditional Chinese Medicine, 2017, 35(5): 8-10. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY201705004.htm
    [16]
    刘春柳, 胡玉英. 胡玉英运用五苓散治疗痰湿内阻型躯体形式障碍经验[J]. 湖南中医杂志, 2019, 35(10): 23-24, 46. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO201910010.htm

    LIU C L, HU Y Y. Hu Yuying's experience of using Wuling Powder in the treatment of phlegm-dampness internal obstruction somatic form disorder[J]. Hunan Journal of Traditional Chinese Medicine, 2019, 35(10): 23-24, 46. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO201910010.htm
    [17]
    HUSAIN M, CHALDER T. Medically unexplained symptoms: Assessment and management[J]. Clin Med (Lond), 2021, 21(1): 13-18.
    [18]
    VAN DEN AKKER L E, BECKERMAN H, COLLETTE E H, et al. Cognitive behavioral therapy positively affects fatigue in patients with multiple sclerosis: Results of a randomized controlled trial[J]. Mult Scler, 2017, 23(11): 1542-1553.
    [19]
    周璇, 张峰. 抗抑郁剂联合内观认知疗法治疗伴有功能性躯体症状的抑郁障碍患者的效果研究[J]. 中国民康医学, 2018, 30(9): 4-7. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMYX201809002.htm

    ZHOU X, ZHANG F. Study on antidepressants combined with Naikan cognitive therapy in treatment of depressive disorder with functional somatic symptoms[J]. Medical Journal of Chinese People's Health, 2018, 30(9): 4-7. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMYX201809002.htm
    [20]
    张恩旭, 张芳, 孙亮, 等. 帕罗西汀联合阿立哌唑对老年躯体化障碍患者血清神经递质含量及交感神经皮肤反应的影响[J]. 中国医药, 2018, 13(11): 1678-1681. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG201811021.htm

    ZHANG E X, ZHANG F, SUN L, et al. Effect of paroxetine combined with aripiprazole on serum neurotransmitter content and sympathetic skin response in elderly patients with somatization disorder[J]. China Medicine, 2018, 13(11): 1678-1681. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG201811021.htm
    [21]
    陈尚茹, 谭朝辉. 文拉法辛联合逍遥丸治疗躯体症状障碍共病抑郁患者的疗效与安全性评价[J]. 广州医科大学学报, 2021, 49(1): 29-32. https://www.cnki.com.cn/Article/CJFDTOTAL-GZXI202101008.htm

    CHEN S R, TAN Z H. Efficacy and safety evaluation of Venlafaxine combined with Xiaoyao Pills in depressive patients comorbid with somatic symptoms[J]. Academic Journal of Guangzhou Medical University, 2021, 49(1): 29-32. https://www.cnki.com.cn/Article/CJFDTOTAL-GZXI202101008.htm
    [22]
    侯宁. 低频重复经颅磁刺激联合度洛西汀治疗躯体化障碍的临床研究[J]. 心理月刊, 2019, 14(16): 10-11. https://www.cnki.com.cn/Article/CJFDTOTAL-XLYK201916005.htm

    HOU N. Clinical study of low frequency repetitive transcranial magnetic stimulation combined with duloxetine in the treatment of somatization disorder[J]. Psychology, 2019, 14(16): 10-11. https://www.cnki.com.cn/Article/CJFDTOTAL-XLYK201916005.htm
    [23]
    汤芳, 蔡飞跃, 刘瑞红, 等. 全科医生-心理治疗师联合团队模式探讨: 以躯体不适为主诉的心理障碍案例报道[J]. 中国全科医学, 2021, 24(13): 1711-1716. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202113019.htm

    TANG F, CAI F Y, LIU R H, et al. General practitioner-psychotherapist team-based care study: A case report of psychological disorder with physical discomforts as the chief complaint[J]. Chinese General Practice, 2021, 24(13): 1711-1716. https://www.cnki.com.cn/Article/CJFDTOTAL-QKYX202113019.htm
    [24]
    杨燕青, 陶莹, 李达, 等. 心身医学在全科实践中的作用思考[J]. 中华全科医学, 2020, 18(6): 998-1001. doi: 10.16766/j.cnki.issn.1674-4152.001412

    YANG Y Q, TAO Y, LI D, et al. Thoughts on the role of psychosomatic medicine in general practice[J]. Chinese Journal of General Practice, 2020, 18(6): 998-1001. doi: 10.16766/j.cnki.issn.1674-4152.001412
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