Azzam Pierre N, Gopalan Priya, Brown Jennifer R, Aquino Patrick R
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Harvard Medical School, Cambridge, MA, USA.
Acad Psychiatry. 2016 Apr;40(2):321-7. doi: 10.1007/s40596-015-0334-9. Epub 2015 Apr 18.
As clinical psychiatry has evolved to mirror the patient care model followed in other medical specialties, psychiatrists are called upon increasingly to utilize general medical skills in routine practice. Psychiatrists who practice in academic settings are often required to generate broad differential diagnoses that include medical and neurologic conditions and, as a result, benefit from incorporating physical examination into their psychiatric assessments. Physical examination allows psychiatrists to follow and to teach patient-informed clinical practices and comprehensive treatment approaches. In this commentary, the authors encourage routine use of a targeted physical examination and outline common scenarios in which physical examination would be useful for the academic psychiatrist: delirium, toxidromes, and unexplained medical conditions (e.g., somatic symptom disorders).
随着临床精神病学的发展,以反映其他医学专科所遵循的患者护理模式,精神科医生越来越多地被要求在日常实践中运用普通医学技能。在学术环境中执业的精神科医生通常需要做出广泛的鉴别诊断,包括医学和神经疾病,因此,将体格检查纳入其精神病学评估中会有所帮助。体格检查使精神科医生能够遵循并传授以患者为导向的临床实践和综合治疗方法。在这篇评论中,作者鼓励常规使用有针对性的体格检查,并概述了体格检查对学术精神科医生有用的常见情况:谵妄、中毒综合征和无法解释的医学状况(如躯体症状障碍)。