目的：擬身體障礙症是臨床診療的一大挑戰，本研究旨在探討擬身體障礙症住院 病人之臨床特徵，並與廣泛性焦慮症住院病人進行比較研究。 方法：選取 1992 年 9 月至 1998 年 4 月間至臺大醫院精神部住院，符合 DSM-IIIR 擬身 體障礙症診斷的患者 55 名為研究組，並選取與研究組住院日期最接近之廣泛性焦慮症住院 病人為對照組，分析其基本資料、臨床病徵、病程及治療等變項。 結果：擬身體障礙症住院病患中，最常見的診斷為未分化型擬身體障礙症，佔 56.4%，其平 均身體症狀數為 4.5 土 2.3 個。 精神病理症狀方面：合併明顯憂鬱症狀者有 13 人， 佔 23.6%； 明顯焦慮症狀者 15 人，佔 27.3 %；合併明顯憂鬱及焦慮症狀者 10 人，佔 18.2% 其病程為慢性、持續性並伴隨生活壓力而加重症狀。與廣泛性焦慮症相較，擬身體障 礙症的臨床特徵為：教育程度低、好發於低杜經階層、發病年齡較小、較慢性化，少主動求 醫；家族史中有類似身體症狀的身體疾病比率為 23.7% (13 人 )，較對照組的比率 5.5%(3 人 ) 還高，有緊張性人格特質之比率比廣泛性焦慮症患者低，發病前有明顯誘發事 件的比率為91%，較廣泛性焦慮症的比率75%為高；擬身體障礙症患者之重複住院率比廣泛性 焦慮症患者高、用藥複雜度高，且治療反應較差。 結論：本研究顯示擬身體障礙症與廣泛性焦慮症在臨床特徵及治療反應等皆有所差異，的確 是二種不同的精神疾患。

　　　　　Objective: Patients with somatoform disorder pose significant management challenges in clinical practice. The present study sought to describe the clinical features of somatoform disorder in psychiatric inpatients and to compare them with those of psychiatric inpatients with generalized anxiety disorder inpatients. Methods: A total of 55 inpatients who were admitted to the psychiatric ward of National Taiwan University Hospital from September 1992 to April 1998 and met the DSM-IIIR criteria of somatoform disorder were enrolled in the study. Another 55 inpatients who met the DSM-IIIR criteria for generalized anxiety disorder were selected from inpatients admitted on the closest index admission to the somatoform disorder patients. Data abstracted from the patients' charts included demographic basic data, clinical characteristics, course and treatment outcome. Results: The most common diagnostic subtype among somatoform disorder inpatients was undiffe-rentiated type, accounting for 56.4% of cases. The mean number of symptoms among pa- tients with undifferentiated somatoform dis- order was 4.5 ± 2.3. Obvious depressive symptoms were identified in 23.6% (n= 13) of the somatoform disorder group and anxious symptoms were identified in 27.3% (n= 15). Mixed anxious and depressive symptoms were found in 18.2% of the somatoform disorder group. The course of somatoform disorder was chronic and persistent with symptoms typically becoming aggravated under stressful life situations. In comparison with generalized anxiety disorder group, the patients in the somatoform disorder group had lower socioeconomic status and were younger and less educated. The somatoform diosrder group had fewer self-motivated psychiatric visiting and were found to be less nervous. Precipitating life events had occurred in 91% of the somatoform disorder group and in 75% of the anxiety disorder group. A family history of compatible physical illness in a first degree relative was noted in 23.7% of the somatoform disorder group and 9.1% of the generalized anxiety disorder group. The readmission rate was higher and treatment outcome was poor- er in the somatoform disorder group. Patients in the somatoform disorder group were prescribed combination therapy more frequently than the generalized anxiety disorder group. Conclusion: Somatoform disorder was different from generalized anxiety disorder in terms of demographics, clinical manifestations and treatment outcome, and it suggests that the two disorders are discrete conditions. ull Text in Chinese)