Silverstone P H
Department of Psychiatry, University of Alberta Hospital, Edmonton, Canada.
J Nerv Ment Dis. 1996 Jan;184(1):43-51. doi: 10.1097/00005053-199601000-00008.
The aim of the present study was to determine the prevalence of psychiatric disorders in acutely ill medical inpatients. A total of 313 consecutively admitted patients were interviewed using a semistructured psychiatric interview. Diagnoses were made according to DSM-IV diagnostic criteria during two time periods, the 7 days following admission and the month prior to admission. The results showed that 85 patients (27.2%) received a DSM-IV diagnosis, with several patients having comorbid diagnoses. Major depressive disorder was present in 16 patients (5.1%), most of whom also had major depressive disorder in the month prior to admission. This prevalence rate is above that of the general population (1.2% to 2.8%), but less than that reported in most previous studies (20% to 40%). Forty-three patients (13.7%) had an adjustment disorder, 18 patients (5.8%) had an anxiety disorder, and 17 patients (5.4%) had either alcohol dependence or abuse. Nurses were more proficient than medical staff at identifying patients who had received a DSM-IV diagnosis, recognizing 61% of cases compared with 41% for medical staff.
本研究的目的是确定急性病内科住院患者中精神障碍的患病率。使用半结构化精神科访谈对总共313名连续入院的患者进行了访谈。在两个时间段内,即入院后7天和入院前1个月,根据《精神疾病诊断与统计手册》第四版(DSM-IV)诊断标准进行诊断。结果显示,85名患者(27.2%)获得了DSM-IV诊断,其中几名患者有共病诊断。16名患者(5.1%)患有重度抑郁症,其中大多数患者在入院前1个月也患有重度抑郁症。这一患病率高于普通人群(1.2%至2.8%),但低于大多数先前研究报告的患病率(20%至40%)。43名患者(13.7%)患有适应障碍,18名患者(5.8%)患有焦虑症,17名患者(5.4%)患有酒精依赖或滥用。护士在识别获得DSM-IV诊断的患者方面比医务人员更熟练,识别出61%的病例,而医务人员为41%。