Woesner Mary E, Marsh Jeremy, Kanofsky J Daniel
Department of Psychiatry, Bronx Psychiatric Center (Drs Woesner and Kanofsky); and Albert Einstein College of Medicine (all authors), Bronx, New York.
Prim Care Companion CNS Disord. 2014 Jul 17;16(4). doi: 10.4088/PCC.14br01639. eCollection 2014.
Physical diseases are difficult to treat in psychiatric patients, whether they are comorbid disorders or mental disorders due to a general medical condition. The psychiatric symptoms are difficult to treat in a medical ward or clinic, and the physical symptoms are difficult to treat in a psychiatric ward or clinic. For this reason, medical-psychiatric units have been developed but remain uncommon. It has been suggested that assertive community treatment (ACT) teams are a way in which to integrate medical and psychiatric treatments. We review the case of a woman with psychiatric symptoms caused by Graves disease that went untreated due to medication noncompliance and unmanageable irritability, aggression, and mood variability. We make a case for the use of the assertive community treatment team in the treatment of patients with mental disorders due to a general medical condition when the psychiatric manifestations are severe and cannot be managed in a medical ward or clinic.
躯体疾病在精神科患者中很难治疗，无论它们是共病性疾病还是由躯体疾病所致的精神障碍。精神症状在内科病房或诊所难以治疗，而躯体症状在精神科病房或诊所也难以治疗。因此，设立了医学-精神科联合单元，但仍不常见。有人提出，积极社区治疗（ACT）团队是整合医学和精神科治疗的一种方式。我们回顾了一例由格雷夫斯病引起精神症状的女性病例，由于药物治疗依从性差以及难以控制的易怒、攻击性和情绪多变，其精神症状未得到治疗。我们认为，当躯体疾病所致精神障碍患者的精神症状严重且在内科病房或诊所无法处理时，可使用积极社区治疗团队来治疗此类患者。
