山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (4): 32-36.doi: 10.6040/j.issn.1673-3770.0.2017.498

• ·论著· • 上一篇    下一篇

鼻科相关的躯体形式障碍

孙淑娟,时蕾,樊兆民,时光刚   

  1. 2014WS0099)第一作者:孙淑娟。 E-mail:402644284@qq.com通讯作者:时光刚。 E-mail:7036285@163.comDOI:10.6040/j.issn.1673-3770.0.2017.498鼻科相关的躯体形式障碍孙淑娟, 时蕾, 樊兆民, 时光刚(山东大学附属省立医院耳鼻咽喉科, 山东 济南 250021
  • 收稿日期:2017-11-27 出版日期:2018-07-20 发布日期:2018-07-20
  • 通讯作者: 时光刚. E-mail:7036285@163.com
  • 基金资助:
    山东省医药卫生科技发展计划项目(2014WS0099)

Nasal related somatoform disorders

SUN Shujuan, SHI Lei, FAN Zhaomin, SHI Guanggang   

  1. Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2017-11-27 Online:2018-07-20 Published:2018-07-20

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摘要： 目的 探讨与鼻科相关的躯体形式障碍的诊断方式和治疗方法。 方法 收治鼻科相关躯体形式障碍的患者,主诉均为反复发作的鼻科相关的鼻塞、脓涕、疼痛、睡眠障碍等,但查体及CT等辅助检查与临床症状相差较大,且有反复的鼻科手术病史。根据相关诊断标准,初步诊断为鼻科相关躯体形式障碍。经过反复与患者本人及家属沟通,给予综合药物治疗、心理治疗及暗示性手术治疗等个体化治疗方案。 结果 患者术后症状缓解,经此手术治疗后,患者精神量表评分均明显好转。术后微信及电话随访,患者已经恢复工作。 结论 心理治疗及暗示性手术等对躯体形式障碍患者有较好的治疗效果。

关键词: 手术, 鼻, 躯体形式障碍, 暗示疗法

Abstract: Objective To study the diagnosis and treatment of nasal related somatoform disorders. Methods In the two patients in our hospital with nasal related somatoform disorders, the main complaints were recurrent nasal obstruction, purulent nasal discharge, pain, sleep disorders, etc. However, their physical examination, and CT scans and other auxiliary examinations did not match their clinical symptoms. The patients always reported a history of repeated nasal surgeries. According to the diagnostic criteria, two patients were initially diagnosed with nasal related somatoform disorders. After further discussion with the patients and their families, we planned individualized treatment programs with comprehensive medical treatment, psychological therapy, and implied surgery, according to the patients disease process. Results Substantial improvements were noted in the two patients after surgery. The patients mental scale scores were significantly improved postoperatively. On WeChat and telephone follow-up, the patients reported that they have begun to work and have an improved quality of life. Conclusion Psychotherapy and implied surgery have a good therapeutic effect on patients with somatoform disorders.

Key words: Surgery, Nose, Implied therapy, Somatoform disorders

中图分类号: 

  • R765
[1] 张朝辉,张亚林. 躯体形式障碍发病机制研究进展[J]. 新乡医学院学报, 2008, 25(3):311-314.
[2] Katon W. Depression: somatic symptoms and medical disorders in primary care[J]. Compr Psychiatry, 1982, 23(3):274-287.
[3] Katon W, Ries RK, Kleinman A. The prevalence of somatization in primary care[J]. Compr Psychiatry, 1984, 25(2):208-215.
[4] Steinhausen HC. Prospects of DSM-III-R[J]. Z Kinder Jugendpsychiatr, 1987, 15(3):224-234.
[5] Lopez Ibor JJ, Frances A, Jones C. Dysthymic disorder: a comparison of DSM-IV and ICD-10 and issues in differential diagnosis[J]. Acta Psychiatr Scand Suppl, 1994, 383(1):12-18.
[6] Shabsigh R, Rowland D. The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision as an appropriate diagnostic for premature ejaculation[J]. J Sex Med, 2007, 4(5):1468-1478.
[7] Rosic T, Kalra S, Samaan Z. Somatic symptom disorder, a new DSM-5 diagnosis of an old clinical challenge[J]. BMJ Case Rep, 2016. DOI:10.1136/bcr-2015-212553.
[8] ICD-10[J]. Commun Dis Rep CDR Wkly, 1992, 2(28):125.
[9] Barsky AJ, Borus JF. Somatization and medicalization in the era of managed care[J]. JAMA, 1995, 274(24):1931-1934.
[10] 孟凡强,崔玉华,沈渔村,等. 综合医院躯体形式障碍临床特点的初步研究[J]. 中国心理卫生杂志, 1999,13(2):67-69. MENG Fanqiang, CUI Yuhua, SHEN Yucun, et al. Perliminary investigation on clinical features of somatof orm disorders in general hospital[J]. Chin Ment Health J, 1999,13(2):67-69.
[11] 汪凯,朱春燕. 应重视综合医院躯体化症状的识别[J]. 中国现代神经疾病杂志, 2016,16(5):247-252. WANG Kai, ZHU Chunyan. Pay attention to the identification of somatization symptoms in general hospitals[J]. Chin J Contemp Neurol Neurosurg, 2016,16(5):247-252.
[12] 胡惠民,粟戟. 交感神经型颈椎病的诊疗探讨[J]. 中国医药指南, 2014(17):162-163.
[13] Verhaak PF, Meijer SA, Visser AP, et al. Persistent presentation of medically unexplained symptoms in general practice[J]. Fam Pract, 2006, 23(4):414-420.
[14] van Ravesteijn H. Mindfulness-based cognitive therapy for patients with somatoform disorders[J]. Tijdschr Psychiatr, 2016, 58(3):198-206.
[15] Kroenke K. Efficacy of treatment for somatoform disorders: a review of randomized controlled trials[J]. Psychosom Med, 2007, 69(9):881-888.
[16] Sitnikova K, Leone SS, Zonneveld LNL, et al. The CIPRUS study, a nurse-led psychological treatment for patients with undifferentiated somatoform disorder in primary care: study protocol for a randomised controlled trial[J]. Trials, 2017, 18(1):206.
[17] 毛洪祥. 持续性躯体形式疼痛障碍患者的心理状态[J]. 临床精神医学杂志, 2003(6):354-355.
[18] Dantzer R. Stress theories and the somatization process[J]. Encephale, 1995, 7(1):3-9.
[19] 孔伶俐,于慧,崔维珍,等. 躯体形式障碍患者的生活事件和防御方式[J]. 中国健康心理学杂志, 2014,22(4):514-516. KONG Lingli, YU Hui, CUI Weizhen, et al. Life events and defense styles in somatoform disorders[J]. Chin J Health Psychol, 2014, 22(4):514-516.
[20] Bach M, Bach D. Predictive value of alexithymia: a prospective study in somatizing patients[J]. Psychother Psychosom, 1995, 64(1):43-48.
[21] 张付全,唐秋萍,刘破资. 述情障碍与躯体化[J]. 国际精神病学杂志, 2005, 32(3):184-186..
[22] Nakao M, Barsky AJ, Kumano H, et al. Relationship between somatosensory amplification and alexithymia in a Japanese psychosomatic clinic[J]. Psychosomatics, 2002, 43(1):55-60.
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