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特集 身体症状症の病態と治療—器質因がはっきりしない身体症状をどう扱うか？
文献概要
抄録 身体症状症に至る発症要因として感情・認知・行動などさまざまな精神医学的要因が考えられている。その病態を明らかにすることは診断，治療を行う上で大変重要である。本稿では身体症状症の中でも痛みが主症状のものに絞った上で概括する。身体症状症ではこれまでの脳画像研究から，体性感覚野のような痛みの感覚に関連のある脳領域というよりも，前頭前皮質，島皮質，前帯状皮質，扁桃体，海馬，大脳基底核といった感情，認知，行動と関連する脳領域の機能異常が明らかになっている。よって痛み感覚の異常というよりも，痛み感覚に対する認識(破局的思考など)，感情(不安，恐怖，抑うつ)，回避的行動(ひきこもりなど)が病態に影響している可能性がある。しかしながらこれまでのところ他の精神疾患に比べて身体症状症の脳画像研究はきわめて少ないのが現状であり，今後さらなる研究成果がまたれる。
参考文献
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