综合医院精神科联络会诊的消化内科住院患者临床特点及复诊影响因素

Clinical characteristics and influencing factors of subsequent visit of inpatients receivingconsultation-liaison psychiatry service in gastroenterology department of general hospital

目的分析综合医院精神科联络会诊的消化内科住院患者临床特点及复诊影响因素。方法回顾性分析某综合医院精神科联络会诊的166例消化内科住院患者的临床资料。总结申请会诊原因、最终精神科诊断、共病情况、精神科处理方案,分析患者出院后至精神科复诊情况及影响因素。结果最常见的会诊原因为患者因存在难以解释或治疗效果不佳的躯体症状而需要排除精神科疾病、有焦虑或抑郁表现。83.7%(139/166)患者最终诊断存在精神科疾病,其中躯体形式障碍及焦虑障碍的比例最高。躯体形式障碍、焦虑障碍、睡眠障碍、抑郁障碍等精神科疾病与功能性胃肠病共病的比例均最高,其次为慢性胃炎。共31例患者给予非药物干预,其余135例患者均接受药物干预。共16例(9.64%)患者出院后至精神科复诊,未能发现对复诊有影响的因素。结论综合医院精神科联络会诊的消化内科住院患者合并精神科疾病比例高,以躯体形式障碍、焦虑障碍最为常见。但综合医院精神科联络会诊的消化内科住院患者出院后精神科复诊率低,应积极寻找影响患者复诊的因素。

Objective To analyze the clinical characteristics and influencing factors of subsequent visit of inpatients receiving consultation-liaison psychiatry service in gastroenterology department of general hospital.Methods The clinical data of 166 inpatients receiving consultation-liaison psychiatry service in gastroenterology department of a general hospital were analyzed retrospectively.The reasons for applying for consultation,ultimate diagnosis of psychiatry,comorbidity,and psychiatric management suggestions were summarized,and the subsequent visit after discharge and its influencing factors were analyzed in the patients.Results The most common reason for consultation was that patients needed to exclude psychiatric diseases for their suffering from unexplained physical symptoms or physical symptoms with poor therapeutic effect,and manifested anxiety or depression.About 83.7%(139/166)of the patients were ultimately diagnosed as psychiatric diseases,and somatoform disorder and anxiety disorder were the major psychiatric diagnosis.The psychiatric diseases,including somatoform disorder,anxiety disorder,sleeping disorder and depression disorder,and functional gastrointestinal disorders,followed by chronic gastritis,were the most common psychiatric comorbidity.Totally 31 patients underwent non-drug interventions,and the remaining 135 patients received drug interventions.In total,16(9.64%)patients performed subsequent psychiatry visit after discharge,and no factors influencing subsequent visit were found.Conclusion The proportion of being complicated with psychiatric diseases is high in inpatients receiving consultation-liaison psychiatry service in gastroenterology department of general hospital,and somatoform disorder and anxiety disorder are the most common diseases.However,inpatients receiving consultation-liaison psychiatry service in gastroenterology department of general hospital exhibit a low rate of subsequent psychiatry visit after discharge,and it is necessary to explore the factors influencing patients′subsequent visit.