综合医院“医学无法解释的躯体症状”患者症状特点及相关因素分析  

Characteristics and relevant factors of somatization symptoms in patients with “medically unexplained symptoms”in general hospital

作　　者：毛雪琴[1] 张蕊[2] 王梦欣[1] 

机构地区：[1]山东大学齐鲁医院心理科,山东济南250012 [2]山东大学齐鲁医院药理基地,山东济南250012

出　　处：《山东大学学报（医学版）》2014年第9期90-94,共5页Journal of Shandong University:Health Sciences

基　　金：济南市科技局企业自主创新资助项目(201101115)

摘　　要：目的探讨"医学无法解释的躯体症状(MUS)"患者症状特点及相关影响因素。方法采用躯体化症状自评量表(SSS)、简易解释性访谈问卷(SEMI)和特质应对方式问卷(TCSQ)分别对MUS患者组50例和对照组30例进行评定。结果与对照组比较,患者组90%的症状严重程度在重度范围;躯体化症状分和消极应对分(NC)平均数均高于对照组(P<0.01),而积极应对(PC)分平均数低于对照组(P<0.01);68%的患者表现为超过6个月(最长5年)的慢性病程,就诊次数超过6次以上,涉及的症状在5种以上;96%的患者表达明显的疾病焦虑,坚信躯体症状提示有较严重的躯体疾病,同时流露明显的情绪反应如害怕死亡及功能丧失等。躯体症状严重程度与应对方式、疾病理念及就诊次数相关。结论 MUS患者有特殊的躯体化症状特点及疾病理念,疾病理念和就诊次数是症状严重程度的重要预测因子。Objective To explore the characteristics of somatization symptoms and the relevant factors in patients with medically unexplained symptoms （MUS）in general hospitals.Methods A total of 50 patients with MUS and 30 healthy controls were assessed with the Somatic Self-rating Scale （SSS）,Trait Coping Style Questionnaire（TCSQ）and Short Explanatory Model Interview （SEMI）.Results Compared with the controls,90%of the patients had severe de-gree of somatization symptoms,and all patients had significantly higher scores of somatization symptoms and negative coping （NC）,but significantly lower scores of positive coping （PC）（P〈0.01）;as many as 68%of the patients had been chronically ill for more than 6 months （ranging from 6 months to 5 years）,with more than 5 symptoms and 6 or more doctor-visits over the past half a year.Up to 96% of the patients expressed significant illness worries,believing that their symptoms indicated serious diseases,and showing obvious fear for death or paralysis.There was significant relation among somatization symptoms,coping styles,illness perception model,and doctor-visits in patients with MUS.Conclusion The MUS patients present distinctive somatization symptoms and illness perception model.Illness perception model and doctor-visits are the important predicting factors for somatization symptoms.

关 键 词：医学无法解释的症状 躯体化症状 疾病理念 

分 类 号：R395.6[哲学宗教—心理学]