精神医学64巻3号

2022年03月発行

特集 精神神経疾患の治療とQOL

身体症状症・疼痛性障害治療とQOL

著者： 西村勝治¹

所属機関： ¹東京女子医科大学医学部精神医学講座

ページ範囲：P.319 - P.326

抄録　身体症状症・疼痛性障害は慢性，難治性であることが多いため，治療の主眼は症状の消失よりも症状への対処，QOLの改善に置かれる。その意味でQOLを治療ゴールとして設定することの意義は大きいが，この疾患群の異種性の高さから疾患特異的QOL尺度の開発が難しいなど，限界もまた大きい。線維筋痛症など一定の均一性を有する疾患では，疾患特異的QOL評価が可能となっており，その知見は参考になる。加えて，身体症状症・疼痛性障害の解釈モデルである破局的認知を中心とした恐怖回避モデルをQOLの視点で読み換え，回復への指標をすることは治療上，有用であると思われる。

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