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機能的ソマティック症候群の管理
Peter Henningsen1, Stephan Zipfel, Wolfgang Herzog
1Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Technical University of Munich, Langerstrasse 3, 81675 Munich, Germany. p.henningsen@tum.de
Lancet (London, England)
|March 21, 2007
まとめ
機能的体症候群 (FSS) の効果的な管理には,段階的なケアアプローチが必要です. 運動や心理療法などの治療に患者の積極的な参加は,これらの複雑な精神的状態に対する被動的介入よりも有益です.
科学分野:
- 精神病体医学は精神病体医学である.
- 臨床心理学の臨床心理学について
- 一般的実践について
背景:
- 機能的ソマティック症候群 (FSS) は重複が大きいが,統一された診断基準がないため,専門分野間の研究と治療を妨げている.
- 現在の治療の研究は,主に個々の症候群に焦点を当て,FSSのより広いスペクトルを無視しています.
研究 の 目的:
- 2001年以降のシステマティック・レビューとメタ分析に基づいて,FSSの全スペクトルの管理戦略をレビューする.
- 複雑でないFSSと複雑なFSSを区別する段階的なケアモデルを提案する.
- FSSの管理のための根拠に基づいた勧告を提供すること.
主な方法:
- 2001年以来発表されたFSSに対する治療研究の体系的レビューとメタ解析.
- 非薬理学的および薬理学的治療効果の分析.
- 異なる治療アプローチ (生物医学,臓器指向,認知対人) の評価.
主要な成果:
- 患者の積極的な関与を必要とする非薬理学的治療法 (例えば,運動,心理療法) は,被動的な身体的措置よりも効果的です.
- 中枢神経系 (CNS) に作用する薬剤は,周辺機能障害を標的とする薬剤よりも一貫した有効性を示しています.
- 生物医学,臓器指向,認知対人戦略を統合したバランスの取れたアプローチは,FSSにとって最適です.
結論:
- 機能的ソマティック症候群の管理には段階的なケアアプローチが推奨され,不合併症と合併症を区別する.
- 積極的で患者中心の非薬理学的介入と中枢神経系に作用する薬剤は,重要な治療成分です.
- イアトロゲン成分に対処し,医師と患者の関係に焦点を当てることは,FSSの成功管理に不可欠です.
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