内科診療における心身症患者と身体表現性障害(心身症と身体表現性障害)(第27回日本心身医学会総会)

概要

論文の詳細を見る
The DSM=III diagnostic trial was performed on patients who visited the Department of Tokai Central Hospital. The relationship between psychosomatic disease and Somatoform Disorders, criticism of the application of the DSM=III, the reliability for diagnosis of psychosomatic disease and multiaxial evaluation of its disease were discussed on the basis of the diagnostic trial performed on these patients. We began by compiling a checklist necessary for the application of the DSM=III diagnosis. Three hundreds and four outpatients who were suffering from neurosis and psychosomatic disease visited the Clinic of Internal Medicine of Tokai Central Hospital and were evaluated using this precompiled checklist. On the basis of this checklist, 17.1% of the patients were Somatoform Disorders. These disorders consisted of Hypochondriasis, the most predominant in the group (51.9%); Conversion Disorder (25%) ; Somatization Disorder (13.5%); and Psychogenic Pain Disorder (9. 6%)' I have been aware of some problems of the DSM=III as a diagnostic method for psychosomatic disease. In some cases, it is difficult to discriminate Somatoform Disorders from Psychological Factors Affecting Physical Condition. It is also difiicult to define those terms which are diagnostic criteria for Psychological Factors Affecting Physical Condition, for example " psychologically meaningful environmental stimuli " and " known pathophysiological process." The definitions of these diagnostic term should be clarified prior to the application of the DSM=III in order to accurately diagnose psychosomatic disease. In Axis I, the group category of Psychological Factors Affecting Physical Condition should be subdevided into some clihical syndromes concerning psychosomatic disease. The important personality tendencies of psychosomatic disease such as alexithymia and characteristic behavior pattern should be considered for the inclusion in Personality Disorders. About Adaptive Functioning, it is necessary to describe whether or not the present adaptive level is lower than that of the past and is in over-function or not. The ethical aspect of psychosomatic disease had to be added as another axis for its evaluation. Deterioration of life style and the subsequent impairment of livelihood are deeply related to psychosomatic disease. This aspect is necessary for the generalized diagnosis of these patients suffering from psychosomatic disease.
日本心身医学会の論文
1987-02-01

内科診療における心身症患者と身体表現性障害(心身症と身体表現性障害)(第27回日本心身医学会総会)

スポンサーリンク

概要

著者

関連論文

スポンサーリンク