Somatoform Disorders軀體病樣精神障礙(一)

Somatization Disorder軀體化失調

A. A history of many physical complaints beginning before age 30 years that occur over a period of several years and result in treatment being sought or significant impairment in social, occupational, or other important areas of functioning.
患者的病史為,從三十歲以前開始不斷地抱怨有各種身體上的不適,並持續數年,患者不斷地求醫,並導致社交,工作和其他重要功能的失常.

B. Each of the following criteria must have been met, with individual symptoms occurring at any time during the course of the disturbance:
以下各項指標都符合,在病程中有單個症狀的發生:

(1) four pain symptoms: a history of pain related to at least four different sites or functions (e.g., head, abdomen, back, joints, extremities, chest, rectum, during menstruation, during sexual interco8use, or during urination)
四中疼痛症狀:病史中有至少四個部位或功能性的疼痛(如:頭痛,腹部痛,後背痛,關節痛,手指或腳趾痛,胸痛,直腸痛,排卵期痛,性交痛,小便時痛)

(2) two gastrointestinal symptoms: a history of at least two gastrointestinal symptoms other than pain (e.g., nausea, bloating, vomiting other than during pregnancy, diarrhea, or intolerance of several different foods)
兩種胃腸道症狀:病史中除痛症外至少有兩種胃腸道症狀(如:惡心,胃脹,非妊娠性嘔吐,腹泄,或者不能忍受幾種不同的食物)

(3) one sexual symptom: a history of at least one sexual or reproductive symptom other than pain (e.g., sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding, vomiting throughout pregnancy)
一種性功能症狀:病史中有至少一種性功能或生殖係統的除痛以外的症狀(如:性冷淡,男性不舉,女性不規則月經,經期出血過多,整個孕期嘔吐)

(4) one pseudo neurological symptoms: a history of at least one symptom or deficit suggesting a neurological condition not limited to pain (conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, seizures: dissociative symptoms such as amnesia, or loss of consciousness other than fainting)
一中假性的神經係統症狀:病史中有至少一項症狀或缺陷與神經係統有關,不僅僅是指神經痛(轉換性症狀,如:協調和平衡失常,癱瘓或局部的肌肉無力,吞咽困難或喉頭有腫塊,失聲,尿瀦留,幻覺,失去痛或觸覺,複視,失明,顛癇發作;分離性症狀,如:失憶或失去知覺)

C. Either (1) or (2):以下的兩項中有一項:

(1) after appropriate investigation, each of the symptoms in Criterion B cannot be fully explained by a known general medical condition or the direct effects of a substance (e.g., a drug of abuse, a medication)
經過各種相關檢查,以上B中所提症狀不能被已知的疾病或某種藥物的直接作用所解釋.

(2) when there is a related general medical condition, the physical complaints or resulting social or occupational impairment are in excess of what would be expected from the history, physical examination, or laboratory findings
即使患者確實患有某種身體疾病,他的主訴也比該病症的症狀和病史要輕的多.
D. The symptoms are not intentionally produced or feigned (as in Factitious Disorder of Malingering).
這些症狀不是故意編造的(與人為障礙病不同).