RESUMO
In this article, we examine research that may lead to a better assessment of psychological factors affecting medical conditions. We performed a review of the psychosomatic literature using both Medline and manual searches. We selected papers that were judged to be relevant to new strategies of assessment, with particular reference to the use of the Diagnostic Criteria for Psychosomatic Research. We assessed 8 areas concerned with the assessment of psychological factors in the setting of medical disease: hypochondriasis, disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, irritable mood, and Type A behavior. A new subclassification of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-V]; not yet published) category of psychological factors affecting physical conditions appears to be feasible and may provide the clinician with better tools for identifying psychological distress.
Assuntos
Medicina Baseada em Evidências , Transtornos Mentais/classificação , Transtornos Mentais/diagnóstico , Doença Crônica/epidemiologia , Doença Crônica/psicologia , Comorbidade , Transtorno Conversivo/classificação , Transtorno Conversivo/diagnóstico , Negação em Psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Hipocondríase/classificação , Hipocondríase/diagnóstico , Humor Irritável , Transtornos Mentais/epidemiologia , Neurastenia/classificação , Neurastenia/diagnóstico , Transtornos Fóbicos/classificação , Transtornos Fóbicos/diagnóstico , Personalidade Tipo ARESUMO
The Diagnostic Criteria for Psychosomatic Research (DCPR) are a diagnostic and conceptual framework that was proposed a decade ago by an international group of investigators. The DCPR's rationale was to translate psychosocial variables that derived from psychosomatic research into operational tools whereby individual patients could be identified. A set of 12 syndromes was developed: health anxiety, thanatophobia, disease phobia, illness denial, persistent somatization, conversion symptoms, functional somatic symptoms secondary to a psychiatric disorder, anniversary reaction, demoralization, irritable mood, type A behavior, and alexithymia. These criteria were meant to be used in a multiaxial approach. The aim of this work is to survey the research evidence which has accumulated on the DCPR, to provide specification for their development and validation and to examine the specific DCPR clusters. Their implications for classification purposes (DSM-V) are also discussed.
