首诊于内科门诊与专科门诊的精神障碍患者临床对比研究

A comparative study in first-diagnosis outpatients with psychiatric disorders between medicine clinic and the specialism

目的:对首诊于内科门诊与专科(精神科或心理科)门诊的精神障碍患者的临床资料进行对比研究。方法:对124例首诊于内科门诊的精神障碍患者(研究组)与142例首诊于专科门诊的精神障碍患者(对照组)的基本临床资料、就诊情况以及医生的诊治进行分析比较,对有关数据进行统计学分析。结果:两组在性别、年龄、文化程度、精神障碍类别上比较,差异存在显著性,女性、中年、文化程度高者以及抑郁症、焦虑症、躯体形式障碍者更倾向于首诊内科。研究组确诊年限长,而且内科医生的诊治存在缺陷。结论:精神障碍患者首诊于内科门诊的原因较多,而提高内科医生对精神障碍的识别水平,建立联络会诊精神病学会减少误诊率,缩短确诊时间。

Objective：To compare the clinical data of the first-diagnosis psychiatric outpatients in medicine clinic and the specialism（ psychosis or psychology specialism）. Methods： clinical data, diagnosis and therapy of doctor were compared between 124 patients in medicine clinic（ study group）and 142 patients in the specialism（ contrast group）. The data analysis was performed with chi -square test. Results： There were significant differences in sex ,age, level of education and psychiatric disorders, female, midlife, high level of education ,depressive disorders,anxiety disorders and somatoform disorders tend to see physician for the first time. Physician of study group spent longer time in correct diagnosis. Besides, diagnosis and therapy of physician had some defect. Conclusions： There are many reasons why outpatients with psychiatric disorders go to see physician for the first time. If the capacity of physician is promoted in distinguishing mental disorders and liaison consultation psychiatry is established ,we will decrease the rate of error diagnosis and shorten the time of providing exact diagnosis.