Kiliç C, Rezaki M, Ustün T B, Gater R A
Hacettepe University Medical School, Department of Psychiatry, Ankara, Turkey.
Soc Psychiatry Psychiatr Epidemiol. 1994 May;29(3):131-6. doi: 10.1007/BF00796493.
This paper describes the pathways that patients take to reach psychiatric services in Ankara. A total of 582 patients were seen in a calendar month in seven centres, two of them being child psychiatric clinics. The pathway in Ankara, unlike may other centres in Europe, is dominated by direct referrals. Only 4% of patients in our sample contacted their general practitioner (GP) first, compared with 42% who first saw hospital doctors and 53% who came direct. Religious healers appeared in the pathway of only 1% of patients, and the delay associated with them was longer. Male patients had longer delays than female patients, and delays were also longer for patients presenting with somatic symptoms. Although the availability of psychiatric services is limited, the median time taken to be seen by the psychiatric services after contacting any carer was only 1 week. The results showed that the referral system for the mental health services is still far from a GP-based system. The patients presenting with somatic symptoms consulted hospital doctors more frequently and were delayed more, pointing to the need for the training of hospital doctors, in addition to GPs, in the recognition and management of common psychiatric disorders.
本文描述了安卡拉患者寻求精神科服务的途径。在一个日历月内，七个中心共接待了582名患者，其中两个是儿童精神科诊所。与欧洲其他许多中心不同，安卡拉的途径以直接转诊为主。在我们的样本中，只有4%的患者首先联系了他们的全科医生（GP），相比之下，42%的患者首先看了医院医生，53%的患者直接前来。宗教治疗师仅出现在1%的患者途径中，且与之相关的延迟更长。男性患者的延迟比女性患者更长，有躯体症状的患者延迟也更长。尽管精神科服务的可及性有限，但在联系任何护理人员后，精神科服务的中位就诊时间仅为1周。结果表明，精神卫生服务的转诊系统仍远非基于全科医生的系统。有躯体症状的患者更频繁地咨询医院医生且延迟更多，这表明除了全科医生外，还需要对医院医生进行常见精神障碍识别和管理方面的培训。
