Revised diagnostic criteria for psychosomatic research and its clinical amplication

doi:10.3877/cma.j.issn.2095-655X.2018.01.003

Abstract

Abstract:

Psychosocial variables and the interaction with biological ones play a crucial role in affecting individual vulnerability, course, and clinical outcome of medical disease, especially the allostatic load related chronic stress.Revised version of diagnostic criteria for psychosomatic research (DCPR) provide new effective modalities of patient care.Macroanalysis is a helpful tool for identifying the relationships between biological, psychosocial variables and the individual targets for medical intervention.Individualized patient care, which includes integrative intervention of medicine and psychology in different phases of various diseases, should be based on integrated assessment strategies as DCPR.The development of subspecialties, such as Psychodematology, Psychocardiology and Psychosomatic gastroenterology, promotes the multidisciplinary organization of health care to overcome defects of sub division refinement.Psychosomatic model of medical should move forward form macroscopic idea to clinical investigation and clinical application.

Key words: Psychosomatic medicine, Pressure, Allostatic load, Clinimetrics, Diagnostic criteria

Jianxin Cao, Qiaoli Zhang. Revised diagnostic criteria for psychosomatic research and its clinical amplication[J]. Chinese Journal of Diagnostics(Electronic Edition), 2018, 06(01): 12-19.

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References 39

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标准	指标
标准A	目前可识别的最近生活事件和/或慢性应激源的存在：应激源在被全面评估时，被认定为过重或超过个人应对能力。
标准B	应激源与以下3个表象的1个或多个相关，这些表象发生在应激后的6个月内。
?	(1)至少有以下两种症状：睡眠困难，睡眠不安，晨间早醒，缺乏活力，眩晕，广泛性焦虑，易激惹性，悲伤，精神消沉；
?	(2)社会或职业功能的显著损伤；
?	(3)环境掌控能力的显著受损，如感到日常生活的不堪重负。

标准	指标
标准A	目前可识别的最近生活事件和/或慢性应激源的存在：应激源在被全面评估时，被认定为过重或超过个人应对能力。
标准B	应激源与以下3个表象的1个或多个相关，这些表象发生在应激后的6个月内。
?	(1)至少有以下两种症状：睡眠困难，睡眠不安，晨间早醒，缺乏活力，眩晕，广泛性焦虑，易激惹性，悲伤，精神消沉；
?	(2)社会或职业功能的显著损伤；
?	(3)环境掌控能力的显著受损，如感到日常生活的不堪重负。

标准	指标
标准A	基于对身体症状的误解，患有严重疾病的恐惧或想法。
标准B	尽管有充分的医学评估和保证，有机会进行讨论和澄清，但偏见仍然存在。
标准C	障碍紊乱持续时间至少6个月。
标准D	偏见在社会和职业功能上造成严重的痛苦和/或损伤。

标准	指标
标准A	基于对身体症状的误解，患有严重疾病的恐惧或想法。
标准B	尽管有充分的医学评估和保证，有机会进行讨论和澄清，但偏见仍然存在。
标准C	障碍紊乱持续时间至少6个月。
标准D	偏见在社会和职业功能上造成严重的痛苦和/或损伤。

标准	指标
标准A	持续的毫无根据的患有某疾病(如艾滋病，癌症)的恐惧，尽管有足够的体格检查和保证，仍有疑虑。
标准B	恐惧倾向于以发作的形式表现，而不是像在疑病症中持续，慢性的担忧；惊恐发作可能是相关特征。
标准C	恐惧的对象不随时间而变化，症状持续时间超过6个月。

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