Linden M, Maier W, Achberger M, Herr R, Helmchen H, Benkert O
Psychiatrische Klinik und Poliklinik der Freien Universität, Berlin.
Nervenarzt. 1996 Mar;67(3):205-15.
As part of an international study initiated by the World Health Organization (WHO) about psychological disorders in primary health care, patients in the Federal Republic of Germany were compared with patients in other European centres. Patients from Germany do not differ from other European patients in respect to sociodemographic variables or psychiatric disorders. The most frequent CIDI-based diagnoses recorded in patients attending general practices are current depressive episodes (8.6%), generalized anxiety disorders (8.5%), neurasthenia (7.5%), and alcohol dependence (6.3%). In 20.9% of the patients at least one psychiatric diagnosis based on ICD-10 was recorded. In Germany significantly lower global ratings of health status are given than in other European centres although there is no difference in diagnostic prevalence rates. The recognition rate, i.e. the agreement between the CIDI-based ICD-10 diagnoses and the recognition as a case by the physician, is 56.2%-60.2%. On the other hand, the CIDI detects 90% of the patients described as psychologically ill by the physicians if subthreshold cases are also counted, or 46.4% if only defined diagnoses are taken into account. There is a significant correlation between severity of the psychiatric disorder and disability in social functioning. In Mainz and in the other European countries the disability rate of patients with a well-defined disorder is between 67.0% and 72.7%, whereas in Berlin this relation is not as clear, because especially in East Berlin there is a higher rate of unemployment in view of the political situation. Drug treatment is prescribed for 16.1% of the patients in primary care for psychiatric disorders. Half the patients recognized by physicians as cases receive medication. In the rest of Europe patients receive significantly more tranquillizers than in Germany, where the use of herbal drugs is more wide spread.
作为世界卫生组织（WHO）发起的一项关于初级卫生保健中心理障碍的国际研究的一部分，对德意志联邦共和国的患者与其他欧洲中心的患者进行了比较。德国患者在社会人口统计学变量或精神疾病方面与其他欧洲患者没有差异。在全科医疗就诊的患者中，基于复合国际诊断访谈（CIDI）记录的最常见诊断是当前抑郁发作（8.6%）、广泛性焦虑障碍（8.5%）、神经衰弱（7.5%）和酒精依赖（6.3%）。在20.9%的患者中，记录到至少一项基于国际疾病分类第10版（ICD - 10）的精神疾病诊断。在德国，尽管诊断患病率没有差异，但健康状况的总体评分明显低于其他欧洲中心。识别率，即基于CIDI的ICD - 10诊断与医生将其识别为病例之间的一致性为56.2% - 60.2%。另一方面，如果将阈下病例也计算在内，CIDI能检测出医生描述为心理疾病患者的90%，如果只考虑明确诊断，则为46.4%。精神疾病的严重程度与社会功能障碍之间存在显著相关性。在美因茨和其他欧洲国家，明确诊断的患者的残疾率在67.0%至72.7%之间，而在柏林这种关系不太明确，因为特别是在东柏林，鉴于政治形势，失业率较高。在初级保健中，16.1%的精神疾病患者接受了药物治疗。医生识别为病例的患者中有一半接受了药物治疗。在欧洲其他地区，患者接受的镇静剂比德国明显更多，而在德国草药的使用更为广泛。
