A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$avghousemoney

Filename: controllers/Article.php

Line Number: 147

Backtrace:

File: /newgeili2020/front/controllers/Article.php
Line: 147
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$avgmoney

Filename: controllers/Article.php

Line Number: 147

Backtrace:

File: /newgeili2020/front/controllers/Article.php
Line: 147
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$sex

Filename: controllers/Article.php

Line Number: 148

Backtrace:

File: /newgeili2020/front/controllers/Article.php
Line: 148
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

躯体形式障碍的病因及治疗 -给力心理
首页 > 心理文章 >

躯体形式障碍的病因及治疗

躯体形式障碍的病因及治疗
转载文章

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$faceJPG

Filename: article/detail.php

Line Number: 9

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 9
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

https://yun.geilixinli.com/@!size60" onerror="this.src='/public/statics/images/default.jpg'"/>

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$nickname

Filename: article/detail.php

Line Number: 9

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 9
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

发表时间:2015-04-23 10:44:28 313 0 0

躯体形式障碍(somatoform disorders)是一类以持久的担心或相信各种躯体不适症状的优势观念为特征的神经症。病人因这些不适的症状而反复就医,各种医学检查正常以及医生的解释均都不能消除其疑虑。有的患者确实存在某种躯体障碍,但症状的性质、严重程度、病人的痛苦和先占观念与躯体障碍严重不符。通常认为这些躯体症状的产生是心理冲突和个性倾向所致,即使症状与心理因素密切相关,可病人不愿意接受,更拒绝探讨心理病因的可能,患者常有明显的焦虑或抑郁情绪。

【病因病机】

1.遗传  现有的一些研究提示躯体形式障碍与遗传有关。如1984年Cloninger等和1986年Sigvardsson等的寄养子研究显示,遗传因素可能与躯体形式障碍的发病有关。但目前尚无定论。

2.个性特征  很多研究显示,多数患者多具有固执、敏感多疑、对健康过度关心的个性特征。他们更多地关注自身的心身状态,使其感觉阈值降低,特别是对躯体感觉的敏感性增加。因此,易出现各种躯体疼痛和不适等。

3.神经生理  躯体形式障碍的患者可能存在脑干网状结构的功能障碍。可能是脑干网状结构或边缘系统等整合滤过功能失调,对自我内在变化的感知增强所致。长时间的感觉变化就可能被患者体会为躯体不适的症状。

4.心理社会因素  父母或其他长辈对疾病的态度,长期与慢性疾病患者一起生活更是易患本病。例如早年的疾病经历、童年期过度的受保护或缺乏照顾都是躯体化障碍的促发因素。文化因素的影响:由于对精神病人甚至是对一些精神症状都有偏见和歧视,使人们愿意表现躯体症状而不是心理症状。另外,因为一些躯体症状更容易得到关怀和照顾。

认知学派认为:由于多数患者具有敏感、多疑,过份自我关注的人格特点,自认为己患有某种尚未诊断出来的疾病而紧张焦虑。然后,反复就医,继之焦虑增加,并导致患者对躯体变化感知选择性增强,稍有变化或不适即能感受。这可能导致一种恶性循环,对自身的变化过敏,引发更多焦虑而出现更多的不适或症状加重。

分析学派认为,躯体症状是个体对外部环境或自身内部恐惧的替代,是一种情绪发泄的方式。Parsons(1951)认为病人通过患病、变换角色,享受特权、取得关心和照顾,可以回避不愿承担的责任而继发受益。

 西医治疗

心理治疗

 心理治疗是主要治疗形式,其目的在于让患者逐渐了解所患疾病之性质,改变其错误的观念,解除或减轻精神因素的影响,使患者对自己的身体情况与健康状态有一个相对正确的评估。目前常用的心理治疗有精神分析、催眠与暗示治疗(可用安慰剂)、行为治疗与认知治疗等,森田疗法对消除疑病观念可能产生良好影响,值得试用。

     病人常常拒绝接受症状的实质在于心理问题,故以提高认知为目的的心理治疗可以帮助病人探究并解决引起症状的内心冲突。但有的病人对这种治疗有阻抗。

    (1)支持性心理治疗:建立良好的医患关系是心理治疗成败的关键。本病患者除诉述众多躯体症状外,还有着漫长而无甚效果的就诊经历,情绪紧张而焦虑。医生要特别耐心倾听患者的倾诉,对患者表示关心、理解和同情;让患者对医生产生信任、对治疗抱有信心。给予病人解释、指导、疏通,使其了解疾病症状有关知识,放下对疾病的思想负担。在治疗过程中医生的接触技巧至关重要。患者常表现依赖性、表演性及受到伤害的疾病行为,好抱怨或感到委屈。有的患者沉湎于痛苦中,习惯于对药物的依赖,有的甚至带有敌意和威胁,使治疗者处于被动地位或缺乏耐心。医生既要对患者的痛苦表示理解,又要引导患者将注意力集中在既定的治疗目标和已获得的成果上,如睡眠的改善、疼痛的减轻等。要勉励病人将轻微的躯体不适如同正常感知的一部分,并与之和平共处;宜逐渐增加活动量,尽量减少不必要的药物。当药物治疗无效时心理治疗更为重要。主要采取系统、个别的短程面谈的方式,每次至少20min,疗程约3个月。治疗的目的在于让患者认识自己的不良疾病行为:分析引发疾病的有关因素;共同寻找解决问题的方法;建立对生活事件及躯体病痛的正确态度。

(2)认知疗法:首先要让患者认识到,虽然病痛是他真实的感受,但并不存在器质性病变,对生命、健康不会带来威胁;要纠正错误的认知,重建正确的疾病概念和对待疾病的态度,学会与症状共存;要转移对疾病的注意,尽量忽视它;并鼓励患者参加力所能及的劳动和其他社交活动。可运用森田疗法使病人了解症状实质并非严重,采取接纳和忍受症状的态度,继续工作、学习和顺其自然地生活,对于缓解疾病症状、提高生活质量可有帮助。

(3)精神动力疗法:精神动力学派认为,慢性心因性疼痛是一种情绪的反应,象征着患者好斗性的升华或失去心爱物的反应,疼痛能使其压抑的内心冲突找到寄托。帮助病人探究并领悟症状背后的内在心理冲突,有助于症状的缓解。

(4)环境及家庭治疗:调整患者所处的环境,对矫正疾病行为、发展健康行为至关重要。医生要协助病人增强对社会环境和家庭的适应能力,鼓励病人努力学会自我调节,尽早摆脱依赖性。有研究表明,短期或长期的家庭治疗对改善患者的人际关系是十分有效的。

(5)催眠暗示疗法:对某些暗示性较强的患者可以试用。一般认为单用催眠治疗效果不大,疗效也不持久。

药物治疗:可用苯二氮卓类如:安定、氯硝安定、氯羥安定(劳拉西泮)、三环类抗抑郁剂如:阿米替林、选择性五羟色胺再摄取抑制剂(SSRIS)如:帕罗西汀、氟西汀、舍曲林等、应用小量抗精神病也是一种选择如:舒必利、奥氮平、奎硫平以及对症处理的镇痛药、镇静药等。用药时应注意从小剂量开始,应向病人说明可能的副作用及起效的时间以增加病人对治疗的依从性。

0人已踩 0人已赞
/">

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$nickname

Filename: article/detail.php

Line Number: 59

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 59
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

本文作者

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$city

Filename: article/detail.php

Line Number: 63

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 63
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$birthday

Filename: article/detail.php

Line Number: 64

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 64
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

0岁
ID:

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$ID

Filename: article/detail.php

Line Number: 66

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 66
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

公益助人

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$freeanswer

Filename: article/detail.php

Line Number: 68

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 68
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

收费助人

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$servicenum

Filename: article/detail.php

Line Number: 68

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 68
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$summary

Filename: article/detail.php

Line Number: 75

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 75
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$longnum

Filename: article/detail.php

Line Number: 81

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 81
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

长程个案

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$addorder

Filename: article/detail.php

Line Number: 82

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 82
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

%

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$addorder

Filename: article/detail.php

Line Number: 83

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 83
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$addorder

Filename: article/detail.php

Line Number: 85

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 85
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

续单率

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$callhours

Filename: article/detail.php

Line Number: 89

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 89
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

咨询时
0 性价比

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$articlenum

Filename: article/detail.php

Line Number: 98

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 98
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

原创文章
作者文章
亲爱的,别让你爱的人自卑
715 4 0
那些鸡汤骗了你
833 1 2
生活中常见的病态心理 你遇到过吗?
857 5 1

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$ID

Filename: article/detail.php

Line Number: 118

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 118
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

/" class="a_home">作者主页
语音通话

A PHP Error was encountered

Severity: Notice

Message: Undefined property: stdClass::$ID

Filename: article/detail.php

Line Number: 121

Backtrace:

File: /newgeili2020/front/views/article/detail.php
Line: 121
Function: _error_handler

File: /newgeili2020/front/controllers/Article.php
Line: 167
Function: view

File: /newgeili2020/front/controllers/Article.php
Line: 187
Function: _detail_pc

File: /newgeili2020/index.php
Line: 344
Function: require_once

)">私聊
相关阅读更多

服务与支持

给力心理APP


给力心理
APP