Berlin R M, Ronthal M, Bixler E O, Kales J D
J Clin Psychiatry. 1983 Jun;44(6):204-6.
The self-report Symptom Checklist-90 (SCL-90) was used to screen 105 consecutive first-visit patients in an outpatient neurology clinic. Neurologists diagnosed a primary psychiatric disorder in 35 patients (33%) and a secondary psychiatric disorder in 5. The SCL-90 uncovered previously unidentified emotional distress in 14 patients, for an overall incidence of psychiatric symptoms of 51%. Pain was the most common chief complaint (N = 49), and pain patients accounted for 86% of the primary psychiatric diagnoses. Tricyclic antidepressants were the most often prescribed medications; 81% of these prescriptions were given to pain patients, usually in low doses. Depression was the most common diagnosis (N = 15). Despite the high incidence of psychiatric symptoms, only 3 patients received a psychiatric referral. Neurologists and consulting psychiatrists should maintain a high index of suspicion for psychiatric symptoms when examining patients complaining of pain and, after assessing the presence and severity of depression, prescribe tricyclics judiciously.
采用自填式症状自评量表90项（SCL - 90）对一家神经内科门诊连续就诊的105例初诊患者进行筛查。神经科医生诊断出35例（33%）患有原发性精神障碍，5例患有继发性精神障碍。SCL - 90发现14例患者存在此前未被识别的情绪困扰，精神症状的总发生率为51%。疼痛是最常见的主要症状（N = 49），疼痛患者占原发性精神障碍诊断病例的86%。三环类抗抑郁药是最常开具的药物；这些处方中有81%是给疼痛患者的，通常剂量较低。抑郁症是最常见的诊断（N = 15）。尽管精神症状发生率较高，但只有3例患者接受了精神科转诊。神经科医生和会诊精神科医生在检查主诉疼痛的患者时，应高度怀疑精神症状，并在评估抑郁的存在和严重程度后，谨慎开具三环类药物。
