协和医学杂志Issue(2)：129-134,6.DOI:10.3969/j.issn.1674-9081.2014.02.001
综合医院门诊多躯体症状患者的躯体疾病和精神心理特点
Physical Illnesses and Psychological Characteristics of Outpatients with Multiple Somatic Symptoms in a General Hospital
摘要
Abstract
Objective To explore the physical diseases and psychological characteristics of patients with multiple somatic symptoms in the outpatient departments in a general hospital .Methods This cross-sectional study was conducted from March to October , 2012.The participants were recruited through convenience sampling from the outpatient departments of Gastroenterology , Traditional Chinese Medicine , and Psychological Medicine in Peking Union Medical College Hospital .Patients in the waiting list were screened continuously by the somatic symptom scale of the Patient Health Questionnaire (PHQ-15).With the cut-off value of 10, patients were divided into the somatic symptom positive (SOM+) group and the control ( SOM-) group.With 25 patients enrolled for each group from all these three departments , totally 150 patients were included .All the subjects completed seven self-as-sessment questionnaires including PHD-15, depression scale of the Patient Health Questionnaire (PHQ-9), Gener-alized Anxiety Disorder 7-item scale ( GAD-7 ) , 12-item Short Form Health Survey ( SF-12 ) , Whiteley-7 Index (WI-7), Sense of Coherence scale (SOC-9), and health care used and health status scales , and received semi-structured interviews including the diagnosed physical and psychological illnesses during the past 12 months and the Mini-International Neuropsychiatric Interview ( MINI ) .Results The proportions of females and subjects with an education degree below college were significantly higher in SOM +group than in SOM-group (69.3%vs 53.3%, 54.8%vs 43.2%, respectively; both P<0.05 ) .While no more physical illness was diagnosed in the past 12 months in the SOM+group.The prevalence of depression , generalized anxiety disorder , and hypochondriasis and the scores of PHQ-9 and WI-7 were significantly higher in the SOM +group ( P<0.05) .The behavior and daily activities of SOM+group patients were also more likely to be influenced by their discomforts (P<0.01).Finally, Logistic regression analysis showed that the high scores of PHQ-9 and WI-7 and unemployment were the influential factors of these manifestations .Conclusions Patients with multiple somatic symptoms do not have more physical illnesses that can be clearly diagnosed .However , they have more psychological distress and lower quality of life , and are more likely to be affected by the symptoms .The high degree of depression and anxiety and unemployment were the influential factors for multiple somatic symptoms .关键词
多躯体症状/躯体症状障碍/躯体症状严重程度量表Key words
multiple somatic symptoms/somatic symptom disorder/somatic symptom scale of the Patient Health Questionnaire分类
医药卫生引用本文复制引用
熊娜娜,洪霞,蒋静,孙夏媛,朱丽明,田国庆,魏镜..综合医院门诊多躯体症状患者的躯体疾病和精神心理特点[J].协和医学杂志,2014,(2):129-134,6.基金项目
中德科学中心项目 （）
