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青少年身心症

Psychosomatic Disorders in Adolescent

摘要


焦慮、憂鬱、強迫、身體化等症狀在青少年十分常見,其中身體化症狀是指醫學上無法解釋的身體症狀,患者常因此四處求醫,影響日常生活功能。本文將介紹此症之在兒童青少年階段的臨床表現、流行病學、以及臨床處理原則。此症在兒童青少年典型的臨床表現可以有多種樣貌,包括:(一)以疼痛為主要表現:嚴重腹痛、頭痛等;(二)以疲倦為主要表現:嚴重倦怠,至少三個月;(三)無法執行正常動作、失去感覺、或假性癲癇等。身體化症狀在兒童青少年均十分常見,尤其是女性。整體而言,此症在較大兒童與青少年發生比例較高,女生比男生常見。大多可在短時間內復原,只有少部分人症狀持續,症狀持續者嚴重度可能逐漸減輕,也可能發展出其他精神科診斷,例如鬱症或恐慌症。適當支持與介入,將能改善成年階段的身心健康。

並列摘要


Anxiety, depression, obsession, and somatic symptoms are common in adolescents. Among these symptoms, unexplained medical symptoms usually suffer the individuals and significantly impair the daily function of the youths. This article focuses on the clinical manifestation, epidemiology, and principle of management of somatic symptom disorders in youths. The common clinical presentations include (1) pain (e.g., abdominal pain, or headache); (2) fatigue (at least 3 months); and (3) sensory or motor deficits (or pseudoseizure). Somatic symptoms are common in children and adolescents, particularly in females and in adolescents. Somatic symptoms are mostly transient, only a few individuals experience persisted somatic symptoms and most of these symptoms decreased gradually as the individuals getting older. Some may develop co-occurring symptoms like depressive or panic symptoms. With adequate support and intervention, the mental health of these individuals can be improved.

參考文獻


陳宜明、黃偉烈、李明濱、廖士程:中文版健康焦慮問卷:心理計量特徵及其與DSM-IV及DSM-5診斷系統之關係。台灣醫學2019;23:21-30。
Tsai SJ, Lee YC, Chang K, et al. Psychiatric consultations in pediatric inpatients. Acta Paediatrica Sinica 1995;36:411-4.
Thapar A, Pine DS, Leckman JF, et al. Rutter Child and Adolescent Psychiatry, 6th edition. Wiley-Blackwell Publishing, 2015.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition, American Psychiatric Association, 2013.
Berntsson LT, Köhler L, Gustafsson JE. Psychosomatic complaints in schoolchildren: a Nordic comparison. Scand J Public Health 2001;29:44-54.

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