儿童的心因性吞咽困难,以及家庭治疗的成功

Reinaldo Batara, I. Ardani, I. Wardani, I. G. Windiani, I. G. A. Adnyana, Yunias Setiawati
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引用次数: 32

摘要

一个人的心理健康与胃肠道疾病有着密切的关系。心因性吞咽困难是一种罕见的与吞咽障碍相关的疾病,没有结构性原因或器质性疾病,如神经缺陷或其他身体疾病。这种吞咽障碍的机制尚不清楚。根据已经进行的各种研究,心因性吞咽困难的情况与心理障碍如焦虑症、抑郁症和创伤后应激障碍共病。在这个病例报告中,我们将报告一个7岁的男性患者,由于害怕呕吐而吞咽困难,心理社会状况紊乱,检查后未发现器质性疾病。BDI检查显示得分为18分,在临床抑郁症的边界内。因此,患者被诊断为心因性吞咽困难,并被纳入DSM 5中的回避/限制性食物摄入障碍类别。该病例需要综合多学科治疗。另据报道,儿科和心理科的医疗成功地减轻了患者的呕吐症状,加上支持性心理治疗和家庭治疗,提高了患者的康复率。
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Psychogenic dysphagia in children, and the success of family-based treatment
There is a close relationship between a person's mental health and gastrointestinal disorders. Psychogenic dysphagia is a rare condition related to swallowing disorders with no structural cause or organic diseases such as neurological deficits or other physical disorders. The mechanism of this swallowing disorder is still not well understood. Based on various studies that have been conducted, the condition of psychogenic dysphagia has comorbidity with psychological disorders such as anxiety disorders, depression, and post-traumatic stress. In this case report, we will present a case of a 7-year-old male patient who had difficulty swallowing due to fear of vomiting with disturbed psychosocial conditions, and no organic disorders were found after the examination. The BDI examination showed a score of 18, which is within the border of clinical depression. So that the patient was diagnosed with psychogenic dysphagia which was included in the category of Avoidant/Restrictive Food Intake Disorder in DSM 5. Holistic and multidisciplinary treatment was needed in this case. It was also reported that the success of medical treatment to reduce the patient's vomiting symptoms from pediatrics and psychologist department, combined with supportive psychotherapy and family-based treatment increases the patient's recovery rate.
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