以生物心理社會模式探討臺大新生之身心症狀

A BIOPSYCHOSOCIAL MODEL TO ASSESS THE PSYCHOSOMATIC SYMPTOMS IN COLLEGE STUDENTS OF NATIONAL TAIWAN UNIVERSTIY

身心症狀約佔學生門診醫療疾病分類中的10%，擔任第一線診療的醫師必須經常處理這類健康問題。本研究首先透過新生健康檢查，排除學生身體構造和機能上之異常，以確定所探討的健康問題為心因性症狀，並假設共同壓力來源為大專聯考，對73學年和74學年之新生施以身心生活適應問卷調查。問卷內容包括過去半年內身心症狀調查與一般健康狀況之自我評量、個人家庭和學校資源評量以及心理症狀調查三部分。其結果對於症狀圈選數、健康評量、情緒化與焦慮反應和無助與憂鬱反應的累積解釋量皆有統計學上的意義。本文提出一種生物心理社會模式，來闡釋身心症狀的發生與壓力、資源、調適策略和反應之間的關係，以供臨床醫師處理身心問題的參考。

About 10% college students with psychosomatic symptoms were seen at the ambulatory clinic in student health center of National Taiwan University. Primary care physicians instead of psychiatrists offen have to take care of by themselves and worked with psychologists as a team approach. The objective. of this study was to investigate the underlying mechanisms of illness processes which used the psychosomatic symptoms as a indicator and healthy status of college freshmen. The methodology combined with compulsory entrance health examination and questionare. The questionare included three parts. e. g. self-report of illness and healthy status in past half year; evaluation of individual, family and school resources; and investigation of various psychological symptoms. Two year data (1984 and 1985) were compared. The results revealed close relations among above three parts. A biopsychosocial model is proposed for primary care physicians as a practical tool to manage the psychosomatic problems.