Bridges K W, Goldberg D P
Br Med J (Clin Res Ed). 1984 Sep 15;289(6446):656-8. doi: 10.1136/bmj.289.6446.656.
The prevalence of psychiatric morbidity in inpatients with neurological disorders and the extent to which it is detected by neurologists were measured by using a two stage model of psychiatric assessment and from information recorded in the patients' medical notes. The prevalence of psychiatric morbidity was estimated as 39%, of which 72% was unrecognised by the neurologists. Only a minority of patients with an uncertain physical diagnosis had a psychiatric illness, showing the error in assuming that a patient's physical symptoms arise from a psychological disturbance if an organic aetiology cannot be determined. When the patients were interviewed on their discharge from hospital they were divided on whether they had wished to discuss their mood with neurologists while they were in hospital. The reasons that they gave suggested that interactions between patients and doctors and the lack of ward facilities for private consultations with doctors are important determinants of hidden psychiatric morbidity in medical inpatients.
采用两阶段精神科评估模型，并根据患者病历记录的信息，对神经系统疾病住院患者的精神疾病患病率以及神经科医生对其的检出程度进行了测量。精神疾病患病率估计为39%，其中72%未被神经科医生识别。只有少数身体诊断不明确的患者患有精神疾病，这表明如果无法确定器质性病因，就假设患者的身体症状源于心理障碍是错误的。当患者出院时接受访谈时，他们被分为是否希望在住院期间与神经科医生讨论自己的情绪。他们给出的理由表明，患者与医生之间的互动以及缺乏与医生进行私人会诊的病房设施是内科住院患者隐藏精神疾病的重要决定因素。
