Srinivasan T N, Suresh T R
Department of Psychiatry, Sri Ramachandra Medical College & Research Institute, Porur, Madras, India.
Gen Hosp Psychiatry. 1990 Jan;12(1):45-9. doi: 10.1016/0163-8343(90)90037-d.
Patients with nonpsychotic minor mental morbidity frequently present with nonspecific somatic symptoms in primary health care settings. This often leads to inappropriate medical management. In this study a group of nonpsychotic psychiatric patients in a general hospital clinic presented with nonspecific somatic complaints as the reason for seeking medical attention (presenting complaint). It was observed that screening of patients with such a presenting complaint lasting for three months or more could differentiate nonpsychotic minor psychiatric morbidity from physical morbidity with high specificity, positive predictive value, and moderate sensitivity. The practical usefulness of such a screening criterion for the nonpsychiatrist physician in a primary medical care setting is discussed.
在初级卫生保健机构中,患有非精神病性轻度精神疾病的患者经常表现出非特异性躯体症状。这常常导致不恰当的医疗处理。在本研究中,一家综合医院门诊的一组非精神病性精神科患者以非特异性躯体主诉作为就医原因(就诊主诉)。据观察,对具有持续三个月或更长时间这种就诊主诉的患者进行筛查,能够以高特异性、阳性预测值和中等敏感性区分非精神病性轻度精神疾病与躯体疾病。本文讨论了这种筛查标准在初级医疗保健环境中对非精神科医生的实际实用性。