Higgins E S
Department of Family Medicine, Medical University of South Carolina, Charleston.
Arch Fam Med. 1994 Oct;3(10):908-17. doi: 10.1001/archfami.3.10.908.
Studies of the prevalence, natural history, and outcome of unrecognized mental illness in general medical outpatient settings were reviewed. Approximately half of the patients with a psychiatric disorder were not recognized as having a mental illness by their primary care physician. The natural history of unrecognized mental illness suggests a poorer clinical course of anxiety disorders but not for depressive disorders. Most interventions demonstrated a significant improvement in the physician's ability to identify and treat psychiatric disorders but had a minimal effect on patient symptoms and no effect on short-term health care use. Although primary care physicians do not recognize psychiatric disorders in a high percentage of patients, efforts to improve recognition may not lead to decreased patient suffering or decreased health care costs.
对普通内科门诊环境中未被识别的精神疾病的患病率、自然史和结局的研究进行了综述。大约一半患有精神疾病的患者未被其初级保健医生识别为患有精神疾病。未被识别的精神疾病的自然史表明，焦虑症的临床病程较差，但抑郁症并非如此。大多数干预措施显示，医生识别和治疗精神疾病的能力有显著提高，但对患者症状的影响极小，对短期医疗保健使用没有影响。虽然初级保健医生在很大比例的患者中未识别出精神疾病，但提高识别率的努力可能不会减轻患者的痛苦或降低医疗保健成本。
