精神科门诊误诊原因分析

Factors of misdiagnosis in psychiatric outpatient department

目的 :探讨精神科门诊首诊误诊的原因。 方法 :按照 CCMD- 2 - R诊断标准 ,对比门诊诊断与住院诊断的差别 ,检出误诊病例 6 5例。 结果 :病程不足 3个月和大于 3年者较易误诊。误诊为神经症者 40 %以上 ,精神分裂症者接近 40 % ,情感性精神障碍 2 0 %。 结论 :精神科门诊首诊误诊的原因可能与病史提供不全面 ,病程较短 。

Objective:To study the factors of misdiagnosis in psychiatric outpatient department during first consulting. Method:According to CCMD 2 R, sixty five misdiagnosed cases were detected by comparing the different diagnosis between outpatient department and inpatient department. Results:The cases whose disease course was less than three months or more than three years were apt to be misdiagnosed. Among them, neurosis and schizophrenia were above and beneath 40% respectively, and affective disorder was 20%. Conclusion:Factors of misdiagnosis in psychiatric outpatient department during first consulting might be as following: insufficient history, short disease course, atypical early symptoms and different diagnostic criteria.