Ishikawa Yukiko, Takeshima Taro, Mise Junichi, Ishikawa Shizukiyo, Matsumura Masami
Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan ; Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.
Int J Gen Med. 2015 Aug 13;8:261-6. doi: 10.2147/IJGM.S82006. eCollection 2015.
General practitioners have an important role in diagnosing a variety of patients, including psychiatric patients with complicated symptoms. We evaluated the relationship between physical symptoms and psychiatric disorders in general internal medicine (GIM) outpatients in a Japanese university hospital.
We coded the symptoms and diagnoses of outpatients from medical documents using the International Classification of Primary Care, second edition (ICPC-2). The participants were new outpatients who consulted the GIM outpatient division at Jichi Medical University Hospital in Tochigi, Japan from January-June, 2012. We reviewed all medical documents and noted symptoms and diagnoses. These were coded using ICPC-2.
A total of 1,194 participants were evaluated, 148 (12.4%) of whom were diagnosed as having psychiatric disorders. The prevalence of depression, anxiety disorder, and somatization was 19.6% (number [n] =29), 14.9% (n=22), and 14.2% (n=21), respectively, among the participants with psychiatric disorders. The presence of several particular symptoms was associated with having a psychiatric disorder as compared with the absence of these symptoms after adjusting for sex, age, and the presence of multiple symptoms (odds ratio [OR] =4.98 [95% confidence interval {CI}: 1.66-14.89] for palpitation; OR =4.36 [95% CI: 2.05-9.39] for dyspnea; OR =3.46 [95% CI: 1.43-8.36] for tiredness; and OR =2.99 [95% CI: 1.75-5.13] for headache).
Not only the psychiatric symptoms, but also some physical symptoms, were associated with psychiatric disorders in GIM outpatients at our university hospital. These results may be of help to general practitioners in appropriately approaching and managing patients with psychiatric disorders.
全科医生在诊断各类患者，包括症状复杂的精神科患者方面发挥着重要作用。我们评估了日本一所大学医院普通内科（GIM）门诊患者身体症状与精神障碍之间的关系。
我们使用《国际初级保健分类》第二版（ICPC - 2）对门诊患者的症状和诊断进行编码。研究对象为2012年1月至6月期间在日本枥木县自治医科大学医院GIM门诊就诊的新患者。我们查阅了所有病历，并记录症状和诊断情况。然后使用ICPC - 2进行编码。
共评估了1194名参与者，其中148名（12.4%）被诊断患有精神障碍。在患有精神障碍的参与者中，抑郁症、焦虑症和躯体化障碍的患病率分别为19.6%（人数[n]=29）、14.9%（n = 22）和14.2%（n = 21）。在调整了性别、年龄和多种症状的存在情况后，与没有这些症状相比，某些特定症状的存在与患有精神障碍相关（心悸的优势比[OR]=4.98[95%置信区间{CI}：1.66 - 14.89]；呼吸困难的OR = 4.36[95% CI：2.05 - 9.39]；疲劳的OR = 3.46[95% CI：1.43 - 8.36]；头痛的OR = 2.99[95% CI：1.75 - 5.13]）。
在我们大学医院的GIM门诊患者中，不仅精神症状，而且一些身体症状也与精神障碍相关。这些结果可能有助于全科医生恰当地诊治和管理精神障碍患者。
