Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, 8730 Alden Drive, Los Angeles, CA 90048, USA.
J Telemed Telecare. 2012 Sep;18(6):317-21. doi: 10.1258/jtt.2012.111113. Epub 2012 Aug 14.
The Cedars-Sinai Telepsychiatry Clinic uses a collaborative-care model to treat patients with developmental disabilities. We examined its practice in four areas: patient characteristics, clinical care, symptom severity and diagnostic outcomes to describe the care provided and the population seen in the telepsychiatry clinic. In a chart review, 45 out of 126 cases were selected and evaluated at three times: initial evaluation, year one and year three. Most of the patients (84%) had an intellectual disability, 55% had a pervasive developmental disorder and 71% spoke approximately 50 words or less. Prior to the initial assessment, none of the patients were diagnosed with anxiety or mood disorders, while almost one-third of patients received one of these diagnoses in the telepsychiatry clinic. Patients were seen six times on average in the first year and three times in the second and third years. The telepsychiatrist recommended a change in the patient's medication for 82% of patients at initial assessment, 41% at year one and 46% at year three. The review suggests that telepsychiatry evaluations can be valuable for patients with developmental disabilities, providing diagnostic clarity and specific recommendations that can be implemented by the primary care physician.
雪松西奈的远程精神病学诊所采用合作式护理模式为发育障碍患者提供治疗。我们从四个方面考察了其实践情况：患者特征、临床护理、症状严重程度和诊断结果，以描述远程精神病学诊所提供的护理和就诊人群。在病历回顾中，我们从 126 例患者中选择了 45 例，并在三个时间点进行了评估：初始评估、第 1 年和第 3 年。大多数患者（84%）有智力障碍，55%有广泛性发育障碍，71%的患者能说大约 50 个词或更少。在初始评估之前，没有患者被诊断为焦虑或情绪障碍，而近三分之一的患者在远程精神病学诊所被诊断出患有这些疾病。患者在第一年平均就诊六次，在第二年和第三年各就诊三次。远程精神病医生在初始评估时建议 82%的患者改变药物治疗，第 1 年为 41%，第 3 年为 46%。综述表明，远程精神病学评估对发育障碍患者可能具有价值，能提供诊断清晰度和具体建议，这些建议可以由初级保健医生实施。
