| 特集名 | 透析医療と他科連携 -- 見逃しやすい疾患を中心に | |
|---|---|---|
| 題名 | 心療内科【機能性身体症候群（FSS）と透析患者】 | |
| 発刊年月 | 2011年 02月 | |
| 著者 | 神原 憲治 | 関西医科大学心療内科学講座 |
| 著者 | 福永 幹彦 | 関西医科大学心療内科学講座 |
| 【 要旨 】 | 身体症状が持続するが，通常の医学的検査で相応した所見が得られず，医学的アプローチが奏功しにくい疾患群は，機能性身体症候群（FSS）と呼ばれている．FSSは主観的な症状と客観的な評価との「ずれ」が症状の遷延や増大につながり，さまざまな問題を伴うため，適切な病態把握と対応が求められている． FSSには心理・社会的問題が関与し，身体面の病態との相関も重要である．不安や抑うつとの関連，治療者・患者関係のすれ違い，周囲との関係性の問題などが挙げられる． 個別の病態と共通の病態を想定し，患者の症状に寄り添って身体的介入や説明を行いつつ，その反応や治療者・患者関係を含めた心理・社会的背景にも着目していくという対応が求められる． |
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| Theme | Working in Cooperation with Other Departments for Dialysis Treatment -- Centered Mainly on Easily Overlooked Conditions | |
|---|---|---|
| Title | Psychosomatic medicine : Functional somatic syndrome (FSS) and dialysis patients | |
| Author | Kenji Kanbara | Psychosomatic Medicine, Kansai Medical University |
| Author | Mikihiko Fukunaga | Psychosomatic Medicine, Kansai Medical University |
| [ Summary ] | Functional somatic syndrome (FSS) refers to several related syndromes which are characterized by persistent somatic symptoms, which can not be explained in medical terms and are difficult to treat. The core pathological concept of FSS is the discrepancy between patients' subjective perceptions of symptoms and objective explanations through medical evaluations. Based on these discrepancies, the symptoms become chronic and increasingly severe, resulting in development of various complications. Because many problems exist in relation to FSS, which upset medical staff members and create economic loss, clarification of the pathology and methods to manage this condition are hoped for. Psychosocial factors, such as anxiety and depression, doctor-patient relationships, and relationships with people in the patients' lives are important for FSS. Relationships between psychosocial factors and physical aspects are also important. Patients with FSS have common problems and disease characteristics ; physiological pathway, mood disturbance, difficult doctor-patient relationships, psychosocial stress, and lack of support systems. In addition, differences in the pathology of diseases such as irritable bowel syndrome, fibromyalgia syndrome also exist. FSS should be treated by both aspects of the similarity and the difference. |
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