Braquehais María Dolores, Valero Sergi, Matalí Josep Lluís, Bel Miquel Jordi, Montejo José Eduardo, Nasillo Viviana, Arteman Antoni, Padrós Jaume, Bruguera Eugeni, Casas Miquel
Galatea Clinic, Galatea Foundation, Barcelona Medical Council-Association, Integral Care Program for Sick Doctors, Barcelona, Spain,
Int J Occup Med Environ Health. 2014 Jun;27(3):435-43. doi: 10.2478/s13382-014-0271-y. Epub 2014 Jun 21.
To explore if the Barcelona Integral Care Program for Doctors with mental disorders (PAIMM, in Catalan) has achieved its goal of enhancing earlier and voluntary help-seeking amongst sick doctors.
We conducted a retrospective chart review of 1363 medical records of physicians admitted to the inpatient and outpatient units of the PAIMM from February 1st, 1998 until December 31st, 2011. The sample was divided into 3 time periods: 1998-2004, 2005-2007 and 2008-2011 (477, 497, and 389 cases, respectively).
The mean age at admission decreased (F = 77.57, p < 0.001) from the first period (x = 54.18; SD = 10.28 years) to the last period (x = 44.81; SD = 10.65 years), while voluntary referrals increased from 81.3% to 91.5% (Chi(2) = 17.85, p < 0.001). Mental disorders other than substance use disorders grew from 71% during the 1998-2003 period, to 87.4% (2004-2007), and 83.9% in the last period (Chi2 = 29.01, p < 0.001). Adjustment disorders increased their prevalence, while inpatient treatment progressively represented less of the overall clinical activity.
Sick doctors may feel encouraged to seek help in non-punitive programs specially designed for them and where treatment becomes mandatory only when there is risk or evidence of malpractice.
探讨巴塞罗那精神障碍医生综合关怀项目（加泰罗尼亚语简称PAIMM）是否实现了促使患病医生更早且自愿寻求帮助这一目标。
我们对1998年2月1日至2011年12月31日期间入住PAIMM住院部和门诊部的1363名医生的病历进行了回顾性分析。样本分为3个时间段：1998 - 2004年、2005 - 2007年和2008 - 2011年（分别为477例、497例和389例）。
入院时的平均年龄从第一个时间段（x = 54.18；标准差 = 10.28岁）到最后一个时间段（x = 44.81；标准差 = 10.65岁）有所下降（F = 77.57，p < 0.001），而自愿转诊率从81.3%增至91.5%（卡方 = 17.85，p < 0.001）。除物质使用障碍外的精神障碍从1998 - 2003年期间的71%增至2004 - 2007年的87.4%，最后一个时间段为83.9%（卡方 = 29.01，p < 0.001）。适应障碍的患病率有所上升，而住院治疗在总体临床活动中所占比例逐渐减少。
患病医生可能会受到鼓励，在专门为他们设计的非惩罚性项目中寻求帮助，且只有在存在风险或有医疗过失证据时才会强制进行治疗。
