Wilkinson G, Smeeton N, Skuse D, Fry J
General Practice Research Unit, Institute of Psychiatry, London.
BMJ. 1988 Sep 24;297(6651):776-8. doi: 10.1136/bmj.297.6651.776.
Patterns of consultation for physical illness were analysed in a body of consultation data covering a continuous 20 year period from a single general practitioner in south London. Three groups of adult patients were identified: patients with a psychiatric disorder and a new prescription for a psychotropic drug; patients with a psychiatric disorder but no new prescription for a psychotropic drug; and a control group without psychiatric disorder. The percentages of patients having one or more consultation for physical illnesses were stable over the years studied, being roughly 90%, 85%, and 60% respectively. For groups identified in 1972 their patterns of consultation for physical illness were examined in 1957, 1962, and annually from 1967 to 1976. In every year studied except 1957 the group with a psychiatric disorder and a new prescription for a psychotropic drug exceeded both other groups in the percentage of patients having one or more consultations for physical illnesses. Both groups with psychiatric disorders had an excess of consultations over the control group; this excess halved in about four years for the group with a new prescription and in about one year for the group without a new prescription. Mental health care by general practitioners for patients with psychiatric disorders does not seem to have an offset effect on general health care of these patients.
对来自伦敦南部一名全科医生连续20年的会诊数据中身体疾病的会诊模式进行了分析。确定了三组成年患者:患有精神障碍且有新的精神药物处方的患者;患有精神障碍但无新的精神药物处方的患者;以及无精神障碍的对照组。在研究的这些年里,有一次或多次身体疾病会诊的患者百分比保持稳定,分别约为90%、85%和60%。对于1972年确定的几组患者,在1957年、1962年以及从1967年到1976年每年对他们的身体疾病会诊模式进行检查。除1957年外,在研究的每一年中,患有精神障碍且有新的精神药物处方的组在有一次或多次身体疾病会诊的患者百分比方面均超过其他两组。两组患有精神障碍的患者的会诊次数均超过对照组;对于有新处方的组,这种超额在大约四年内减半,而对于无新处方的组,在大约一年内减半。全科医生为患有精神障碍的患者提供的心理健康护理似乎对这些患者的整体医疗保健没有抵消作用。