Fulop G, Strain J J
Gen Hosp Psychiatry. 1985 Jul;7(3):267-71. doi: 10.1016/0163-8343(85)90079-9.
Medical and surgical inpatients who referred themselves for psychiatric consultation are characterized. The 25 "self-referred" compared to 787 "others" referred to the Consultation-Liaison Psychiatry Division were more likely to state depression (52%/25%) and anxiety (36%/11%) as reasons for referral. "Self-referrals" were less likely to be referred by physicians for behavior management (8%/23%), general diagnosis (4%/22%) or suicide evaluation (4%/25%). The "self-referral" represents a challenge to the current medical model referral mechanism in which the physician controls access to consultants. The data indicate that there should be a mechanism for the patient's contribution to the referral process and that increased sensitivity to psychologic difficulties in coping with medical illness would improve the use of psychiatric consultation in the medical setting.
对主动寻求精神科会诊的内科和外科住院患者的特征进行了研究。与转介至会诊 - 联络精神科的787名“其他患者”相比，25名“主动求诊者”更有可能将抑郁（52%/25%）和焦虑（36%/11%）作为求诊原因。“主动求诊者”被医生转介进行行为管理（8%/23%）、一般诊断（4%/22%）或自杀评估（4%/25%）的可能性较小。“主动求诊”对当前由医生控制会诊渠道的医疗模式转诊机制构成了挑战。数据表明，应该建立一种机制，让患者能够参与转诊过程，并且提高对患者在应对疾病过程中出现心理困难的敏感度，这将改善在医疗环境中精神科会诊的利用情况。
