Feinberg T E, Roane D M, Miner C R, Kaufman H, Cantillon M
Neurobehavior and Alzheimer's Disease Center, Beth Israel Medical Center, New York, NY 10003, USA.
J Neuropsychiatry Clin Neurosci. 1995 Spring;7(2):145-54. doi: 10.1176/jnp.7.2.145.
In a retrospective case review of 336 outpatients who underwent neuropsychiatric evaluations, patients were sorted into five groups: 1) atypical psychiatric; 2) atypical neurological; 3) prior psychiatric/new-onset neurological; 4) prior neurological/new-onset psychiatric; 5) dementia versus pseudodementia. Cluster analysis of 19 presenting complaints differentiated among groups. Post-consultation changes in preconsultation diagnosis occurred frequently overall, with more new case finding for psychiatric than for neurological disorders. For example, mood disorder diagnoses increased from 7.7% to 16.1%. Overall, dementia was the most common postconsultation diagnosis (32.8%). The authors conclude that suspicion for dementia should be high in neuropsychiatric referrals and that mood disorders may be especially common in neuropsychiatric patients.
在一项对336名接受神经精神评估的门诊患者的回顾性病例分析中，患者被分为五组：1）非典型精神疾病；2）非典型神经疾病；3）既往有精神疾病/新发神经疾病；4）既往有神经疾病/新发精神疾病；5）痴呆与假性痴呆。对19项就诊主诉进行聚类分析可区分不同组。总体而言，会诊后初诊诊断的变化很常见，精神疾病的新病例发现多于神经疾病。例如，情绪障碍诊断从7.7%增至16.1%。总体而言，痴呆是会诊后最常见的诊断（32.8%）。作者得出结论，在神经精神转诊中对痴呆的怀疑应很高，并且情绪障碍在神经精神患者中可能尤其常见。
