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急诊科精神病患者的躯体管理。

Somatic Management of Psychiatric Patients in the Emergency Department.

机构信息

Faculty of Medicine, Université Libre de Bruxelles, Place A. Van Gehucten 4, B1020 Brussels, Belgium,

出版信息

Psychiatr Danub. 2023 Oct;35(Suppl 2):341-346.

PMID:37800253
Abstract

This retrospective study aims to assess a potential difference in the management of patients with a psychiatric history in somatic emergencies. Indeed, the psychiatric population has higher mortality and morbidity rates than the general population. The negative stigmatization of patients with mental health disorders remains one of the factors to consider when studying this morbidity and mortality. In this context, adult patients diagnosed with myocardial infarction, pulmonary embolism, stroke, acute cholecystitis or appendicitis in the emergency department of the Brugmann University Hospital Center during the year 2021 were selected. The presence or absence of a history psychiatric was then recorded for each patient. Different key intervention times, the total length of stay and the occurrence of complications were also studied for 459 patients, 74 of which had a history psychiatric. A significant difference in the time preceding the prescription of the first complementary examination for patients with a psychiatric history was thus highlighted. No other differences in care were demonstrated within the limits of this sample. This difference could be associated with the phenomenon of diagnostic overshadowing. It is the fact of associating the somatic complaints of a patient with his psychiatric pathology. Another potential explanation, present in the literature, could be the discomfort felt by somaticians when dealing with psychiatric patients. Finally, the integration of the experience of psychiatric patients into the training of physicians and the question of the relevance of applying the triage system to psychiatric patients were raised as potential future studies.

摘要

这项回顾性研究旨在评估躯体急症患者的精神病史管理方面可能存在的差异。事实上,精神疾病患者的死亡率和发病率高于一般人群。对精神健康障碍患者的负面污名化仍然是研究这种发病率和死亡率时需要考虑的因素之一。在这种情况下,选择了 2021 年在布鲁格曼大学医院中心急诊科诊断为心肌梗死、肺栓塞、中风、急性胆囊炎或阑尾炎的成年患者。然后为每位患者记录是否存在精神病史。对 459 名患者中的 74 名有精神病史的患者研究了不同的关键干预时间、总住院时间和并发症的发生情况。因此,突出了有精神病史患者的首次补充检查的处方时间存在显著差异。在这个样本范围内,没有发现护理方面的其他差异。这种差异可能与诊断掩盖现象有关。这是一种将患者的躯体症状与其精神病理学联系起来的现象。文献中还提到了另一个潜在的解释,即躯体医生在处理精神科患者时感到的不适。最后,提出了将精神科患者的经验纳入医生培训以及对分诊系统是否适用于精神科患者进行质疑作为潜在的未来研究。

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