Mayou R, Hawton K, Feldman E, Ardern M
University Department of Psychiatry, Oxford, United Kingdom.
Int J Psychiatry Med. 1991;21(1):71-84. doi: 10.2190/NDPB-YCW9-BETA-AYJE.
The prevalence, nature, associations and outcome of psychiatric morbidity among four hundred and fifty severe general medical admissions are described. Affective disorder was diagnosed in 13 percent of men and 17 percent of women. It was associated with a history of previous psychiatric disorder and current social problems. Persistent affective disorder after discharge was associated with continuing medical and social problems. Alcohol problems were common in men, especially in those with social problems, and often went unrecognized by medical staff. Cognitive impairment was confined to the elderly and was associated with longer hospital stay and high mortality. Patients with emotional and cognitive disorder make considerable demands on medical, social and psychiatric services during and following admission. The implications for improved recognition and management of psychiatric morbidity in general medical patients are discussed.
本文描述了450例严重内科疾病住院患者中精神疾病的患病率、性质、关联因素及转归情况。情感障碍在男性患者中的诊断率为13%，女性患者中为17%。它与既往精神疾病史及当前社会问题相关。出院后持续性情感障碍与持续存在的医疗和社会问题有关。酒精问题在男性中很常见，尤其是那些有社会问题的男性，且常常未被医护人员识别。认知障碍仅限于老年人，与住院时间延长及高死亡率相关。情感和认知障碍患者在住院期间及出院后对医疗、社会和精神科服务提出了相当大的需求。文中还讨论了提高对普通内科患者精神疾病的识别和管理的意义。
