Popkin M K, Mackenzie T B, Callies A L
J Nerv Ment Dis. 1980 Jan;168(1):9-12. doi: 10.1097/00005053-198001000-00003.
Consultees' concordance with psychiatric consultants' recommendations for diagnostic action was studied retrospectively. Of 381 initial consultations reviewd, 110 (29 per cent) contained one or more recommendations for diagnostic action. Consultees' responses were rated concordant in only 53 per cent of these cases. This disturbing outcome, reflecting broad resistance to consultants' practice of making recommendations for diagnostic action, is attributed to consultees' use of a functional vs. organic dichotomy regarding psychiatric disorder. The functional category is argued to be perceived by consultees as a nonmedical entity. As the psychiatrist is invoked to deal with this nonmedical entity, he is seen in other than the medical mode and inconsistently afforded medical privilege. The work implies how wide the gap to medical credibility may be for psychiatric consultants and the need for new consultation strategies incorporating this cognizance.
我们对咨询者与精神科顾问关于诊断行动的建议的一致性进行了回顾性研究。在审查的381例初始咨询中，110例（29%）包含一项或多项诊断行动建议。在这些案例中，咨询者的回应只有53%被评为一致。这一令人不安的结果反映了对顾问提出诊断行动建议做法的广泛抵制，这归因于咨询者在精神疾病方面采用功能性与器质性二分法。有人认为，咨询者将功能性类别视为非医学实体。由于请精神科医生来处理这个非医学实体，他被视为处于非医学模式，并且没有始终如一地获得医疗特权。这项研究表明，精神科顾问在医学可信度方面的差距可能有多大，以及需要结合这种认识的新的咨询策略。
