van Hemert A M, Hengeveld M W, Bolk J H, Rooijmans H G, Vandenbroucke J P
Department of Psychiatry, Leiden University Hospital, The Netherlands.
Psychol Med. 1993 Feb;23(1):167-73. doi: 10.1017/s0033291700038952.
In many patients clinical care in general medical settings is complicated by the presence of psychiatric disorders in addition to the presenting physical symptoms. In the present study the prevalence and type of psychiatric disorders was assessed in relation to the medical diagnostic findings in a general internal medicine out-patient clinic. The Present State Examination, a standardized psychiatric interview, was used to detect psychiatric disorders in 191 newly referred patients. Psychiatric disorders were found to be particularly prevalent among patients with medically ill-explained or unexplained symptoms. The prevalence of psychiatric disorders was 15% for patients with a medical explanation for their presenting symptom, 45% for patients with ill-explained and 38% for those with unexplained symptoms. Approximately 40% of the patients with psychiatric disorders met DSM-III-R criteria for somatization disorder or hypochondriasis, suggesting that these disorders contributed in particular to general medical out-patient referrals.
在许多患者中，除了当前出现的身体症状外，精神障碍的存在使普通医疗环境中的临床护理变得复杂。在本研究中，在一家普通内科门诊诊所，针对精神障碍的患病率和类型与医学诊断结果的关系进行了评估。使用标准化的精神科访谈《现状检查》对191名新转诊患者进行精神障碍检测。结果发现，精神障碍在有医学原因可解释或无法解释症状的患者中尤为普遍。对于有医学原因解释其当前症状的患者，精神障碍患病率为15%；对于原因不明的患者，患病率为45%；对于症状无法解释的患者，患病率为38%。约40%患有精神障碍的患者符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中躯体化障碍或疑病症的标准，这表明这些障碍尤其导致了普通内科门诊的转诊。
