Pawłowski Tomasz, Baranowski Piotr, Małyszczak Krzysztof, Kiejna Andrzej
Kliniki Psychiatrii AM we Wrocławiu.
Psychiatr Pol. 2004 Jul-Aug;38(4):685-95.
The aim of this study was to analyse the treatment methods at the different stages of the pathway to psychiatric care.
In a period of two months all patients age 15 and over who applied to the Psychiatric Service in the Zabkowice catchment area and Psie-Pole catchment area were assessed by psychiatrists for their eligibility to enter the study. Those who had fulfilled the entry criteria were interviewed using a Polish version of WHO's encounter form (EF) by the mental health professionals during their initial interview.
A total of 228 patients (105 men and 123 women) were seen. Encounter forms were completed on 200 people. 28 patients refused to answer some of the questions. There were significant differences in treatments offered to patients by hospital doctors and medical specialists, general practitioners (GP's) and psychiatrists. Our data show that sedative/hypnotics are the main psychotropic drugs prescribed by GP's. The small percentage of antidepressant (10% of all psychotropic drugs) used by GP's and medical specialists was noteworthy. They didn't decide to prescribe neuroleptics to their patients.
The study revealed that GP's, hospital doctor & medical specialists prescribed antidepressant and neuroleptics far too rarely and GP's far too often prescribed sedative/hypnotics. This can indicate that they have difficulties in diagnosing of mental disorders as well as poor knowledge concerning indications relating the use of psychotropic drugs.
本研究旨在分析精神科护理流程不同阶段的治疗方法。
在两个月的时间里,精神病医生对所有年龄在15岁及以上、申请扎布科维采集水区和Psie-Pole集水区精神科服务的患者进行资格评估,以确定其是否适合进入研究。符合入选标准的患者在初次面谈时由心理健康专业人员使用波兰语版的世界卫生组织会诊表(EF)进行访谈。
共接待了228名患者(105名男性和123名女性)。为200人填写了会诊表。28名患者拒绝回答部分问题。医院医生、医学专家、全科医生(GP)和精神科医生为患者提供的治疗存在显著差异。我们的数据显示,镇静/催眠药是全科医生开出的主要精神药物。全科医生和医学专家使用的抗抑郁药比例较小(占所有精神药物的10%),这一点值得注意。他们没有决定给患者开抗精神病药。
研究表明,全科医生、医院医生和医学专家开出抗抑郁药和抗精神病药的频率过低,而全科医生开出镇静/催眠药的频率过高。这可能表明他们在精神障碍诊断方面存在困难,并且对精神药物使用指征的了解不足。