내과계 입원환자들에서 정신신체장애의 유병율과 스트레스지각

The Prevalence of Psychosomatic Disorders and Stress Perception in Medical inpatients

36.3% of medical inpatients were shown to have psychiatric problems and 71.4% of them were shown to be psychosomatic patients. A considerable number of patients were found to be resistant to psychiatric approach, which was associated with low stress perception. Stress perception was noted to be in part influenced by sex, age and education in those patients. Their negative life events made a broader influence on stress perception than positive ones. The scores of stress perception in the patients were significantly lower than those of the normal control group in most of items except economic problems. On the other hand, the frequency of negative life events in the former was higher than that in the latter. The scores of stress perception in a group of psychosomatic patients were higher than those in a group of non-psychosomatic patients. The patients showed a positive correlation between the severity of physical symptoms and the scores of stress perception in some items, and between the severity of psychic distress and the scores of stress perception in all the items. This suggests that the degree of stress perception is more related to emotional aspects than physical ones. The above results suggest that psychosomatic or biopsychosocial apprach is necessary in management of medical inpatients and that high stress perception and negative life events are associated with physical diseases. Paradoxically, however, it is also suggested that low stress perception prevents from resolving their fundamental problems. This could provide a rationale for clinical application of biofeedback treatment and cognitive therapy in those patients.