RESUMO
There is increasing awareness of the limitations of disease as the primary focus of medical care. It is not that certain disorders lack an organic explanation, but that our assessment is inadequate in most clinical encounters. The primary goal of psychosomatic medicine is to correct this inadequacy by incorporation of its operational strategies into clinical practice. At present, the research evidence which has accumulated in psychosomatic medicine offers unprecedented opportunities for the identification and treatment of medical problems. Taking full advantage of clinimetric methods (such as with the use of Emmelkamp's two levels of functional analysis and the Diagnostic Criteria for Psychosomatic Research) may greatly improve the clinical process, including shared-decision making and self-management. Endorsement of the psychosomatic perspective may better clarify the pathophysiological links and mechanisms underlying symptom presentation. Pointing to individually targeted methods may improve final outcomes and quality of life.
Assuntos
Determinação da Personalidade , Transtornos Psicofisiológicos/diagnóstico , Adulto , Alostase , Terapia Combinada , Comorbidade , Comportamento Cooperativo , Feminino , Humanos , Hipotireoidismo/diagnóstico , Hipotireoidismo/psicologia , Comportamento de Doença , Comunicação Interdisciplinar , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/psicologia , Acontecimentos que Mudam a Vida , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Prognóstico , Transtornos Psicofisiológicos/classificação , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/terapiaRESUMO
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.
