Balestrieri M, Bon M G, Rodriguez-Sacristan A, Tansella M
Servizio di Psicologia Medica, Università di Verona, Italy.
Psychol Med. 1994 Aug;24(3):641-9. doi: 10.1017/s0033291700027793.
This paper compares the pathway to psychiatric care of patients contacting the South-Verona Community Psychiatrics Service (CPS) with the pathways described in other countries, using the method of the WHO cross-cultural study of pathways in psychiatric care. One hundred and sixteen South-Verona residents starting new episodes of care were traced and included in the study. The first port of call for 92% of patients was a doctor. More than one-third arrived at the CPS directly, not filtered by other carers. One-third went first to the GP and then straight to the CPS. Both the median total interval since onset of symptoms and the median interval between onset of the problem and first seeking care was 8 weeks. Patients presenting first at the two major ports of call tend to have a quite similar latency period before seeking care. Problems presented are represented mostly by depression and anxiety. The diagnosis of affective disorders occurred in more than half of the sample, followed by neurotic and somatoform disorders and schizophrenia and related disorders. The intervals after seeing the first carer are short and quite homogeneous among all patients. More than three-quarters of the patients said that they received some form of treatment for their presenting problems prior to arrival at the CPS, mostly psychopharmacotherapy with sedatives/hypnotics. These results are discussed in the light of those obtained in the WHO cross-cultural study.
本文采用世界卫生组织精神科护理途径跨文化研究方法,将联系南维罗纳社区精神科服务(CPS)的患者的精神科护理途径与其他国家描述的途径进行比较。对116名开始新护理阶段的南维罗纳居民进行追踪并纳入研究。92%的患者的第一求助对象是医生。超过三分之一的患者直接到达CPS,没有经过其他护理人员的筛选。三分之一的患者先去看全科医生,然后直接去CPS。自症状出现以来的总间隔中位数以及问题出现与首次寻求护理之间的间隔中位数均为8周。首先在两个主要求助对象处就诊的患者在寻求护理之前往往有相当相似的潜伏期。所呈现的问题主要是抑郁症和焦虑症。超过一半的样本被诊断为情感障碍,其次是神经症和躯体形式障碍以及精神分裂症和相关障碍。在所有患者中,见到首位护理人员后的间隔时间较短且相当一致。超过四分之三的患者表示,在到达CPS之前,他们针对所呈现的问题接受了某种形式的治疗,主要是使用镇静剂/催眠药的心理药物治疗。根据世界卫生组织跨文化研究获得的结果对这些结果进行了讨论。