綜合醫院精神科照會現況之臨床分析

A Clinical Investigation of Psychiatric Consulation in a General Hospital

李鶯喬(Ying-Chiao Lee) ； 張凱理(Kelly Chang) ； 臧汝芬(Ruu-Fen Tzang) ； 馬景野(Cheng-Yea Ma) ； 湯元皓(Yuan-How Tong)

《Journal of Medical Sciences》 17卷4期 (1997/02) Pp. 214-223

摘要

本篇報告蒐集某綜合醫院共五個月期間，照會精神科之549位（592人次）個案資料作分析，以探討精神科轉介形態之現況。結果發現當時期間總照會率2.19%，男：女比例為1.6：1，年齡分佈以60至69歲及70至79歲為最多，男性平均年齡顯著高於女性。不同科、部間照會率最高者依序為毒物科（45.57%）、復健醫學部（12.5%）、呼吸治療科（6.78%）、家庭醫學科（6.19%）及神經內科（5.84%）。精神科診斷分佈最高者依序為：器質性精神障礙症（35.6%）、適應障礙症（14.9%）及情感症（13.5%）。某些診斷有顯著男、女流行率差異：癡呆症、譫妄症及藥物濫用相關症中，男多於女；重鬱症、雙極症及焦慮症中，女多於男。主要照會理由最多者依序為：要求作鑑別診斷（28.6%）、干擾行為（16.6%）、情緒反應（15.3%）、及自殺（12.6%）。患者出院後三個月內之精神科門診追蹤率為26.0%。

關鍵字

綜合醫院 ； 精神科照會

並列摘要

549 hospitalized inpatients at a general hospital had been interviewed by psychiatric consultation team members through psychiatric consultation service within a five-month interval. Totally 592 times (549 cases) of psychiatric consultation was requested. The referral pattern was investigated. Consultation rate was 2.19 %. Male to female ratio was 1.6:1. The highest proportion in total sample were 60-69 years old and 70-79 years old cases. The mean age of male cases was significantly higher than that of female cases. The highest proportion in female sample were 30-39 and 40-49 years old.The highest consultaion rate in various sections were as follows: Toxicology section (45.57%), Rehabilitation department (12.5%), Respiratory therapy section (6.78%), Family medicine section (6.19%) and Neurology section (5.84%). The highest proportion in the psychiatric diagnostic distributions were organic mental disorders (35.6%), adjustmental disorders (14.9%) and Mood disorders (13.5%). There existed significant sex difference on the prevalence rate in some psychiatric diagnosis: In dementia and delirium, as well as in substance related disorder, it showed male cases significantly predominant than female cases; while in major depression, bipolar disorder and anxiety disorder, it showed female cases significantly predominant than male cases. The most common main reasons for referral were as follows: Asking for differential diagnosis (28.6%); Disturbing behavior (16.0%); emotional reaction (15.3%) and suicide (12.6%). The rate of psychiatric OPD follow up three months after discharge was 26.0%.

並列關鍵字

General Hospital ； Psychiatric Consultation