综合医院精神心理科会诊患者特点分析

Analysis of patient characteristics in each department of psychiatric consultation in general hospital

目的 了解综合医院精神心理科联络会诊的原因、患者的科室分布、病种构成及处理情况,以更好地指导精神心理科医生的联络会诊工作,为进一步完善会诊精神医学在综合医院内的发展提供参考.方法 本研究采用回顾性方法复习综合医院住院患者的精神科会诊情况,分析在现代医学模式下综合医院的患者对精神卫生服务需求的特点,汇总2012年1月-2013年12月精神心理科联络会诊病历,资料完整者共612例,对一般人口资料、各科会诊人数及病种构成、会诊原因、诊断、处理构成等情况进行描述分析.结果 全部临床科室都有邀请精神心理科会诊,比例最高的科室前5位为：神经内科113例（18.5％）、心血管内科83例（13.6％）、消化内科69例（11.3％）、干部科56例（9.2％）、急诊科52例（8.5％）.病种主要为神经症性、应激相关的及躯体形式障碍151例（24.7％）,心境障碍139例（22.7％）,器质性精神障碍108例（17.6％）,伴有生理紊乱和躯体因素的行为综合征84例（13.7％）;精神科用药以SSRIs类药物、非典型抗精神病药物及苯二氮革类应用较多.结论 综合性医院各科存在较多的精神医学问题,住院患者伴发的精神障碍涉及各类疾病,综合医院就诊的患者精神心理障碍应引起重视,精神科会诊联络非常重要,可以提高临床各科医师对精神障碍的认识,减少或消除人们对精神科会诊的顾虑与不信任,提高会诊效率,治疗躯体疾病的同时应及时使用心理和药物等多种干预手段,使患者得到全面康复,从而提高患者的生命质量.

Objective To evaluate the psychological consultation liaison department of general hospital in patient distribution, composition of diseases and therapeutic effect, and the consultation liaison work in order to better guide the psychologists and the development of a new model of the consultation liaison psychiatry and to provide guidance for the development of further psychological consultation in general hospital. Methods In this study, the retrospective method was used to evaluate the general hospital psychiatric consultation cases of hospitalized patients, characteristics of the health service de- mand of spiritual analysis of general hospital under the modern medical model of patients. A total of 612 cases with complete data between January 2012 and December 2013 in our hospital psychiatric consultation liaison records were analyzed using SPSS 16.0 statistical analysis in general population data, the number of various consultation and disease composition causes, diagnosis, treatment, and consultation. Results All clinical departments have invited psychiatric consultation. The departments and proportion of the top five were neurology department （113 cases, 18. 5%）, cardiology department （83 cases, 13.6 %）, gastroenterology department （ 69 cases, 11. 3%）, personnel department （56 cases, 9. 2 %）, emergency department in（52 cases, 8.5 %）. Diseases was mainly of neurosis and stress--related and somatoform disorders in 151 cases （24.7%）, mood disorders in 139 cases （22.7%）, organic mental disor ders in 108 cases （17.6G）, accompanied by physiological disorders and somatic factors behavior syndrome in 84 cases （13. 7G）. Psychiatric medications were SSRIs drugs, Atypieal antipsychotics and benzodiazepines class. Conclusions General hospital psychiatric problems exist. The patients with comorbid psychiatric disorders are often associated with various diseases. General hospital with patients with mental disorders should seek consultation. The psychiatric consultation liaison is very important to improve the clinical understanding of mental disorders and to reduce or eliminate the concerns about psychiatric consultations or distrust and to improve the diagnosis accuracy. The treatment of body disease should be timely combined with psychological and other means of intervention. The quality of life in patients received comprehensive rehabilitation better improved.