Judd F K, Cockram A, Mijch A, McKenzie D
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Aust N Z J Psychiatry. 1997 Jun;31(3):391-7. doi: 10.3109/00048679709073849.
To provide an overview of the work of a liaison psychiatry service to an HIV/AIDS inpatient unit, and particularly to examine the identification of mood and related disorders by referring doctors.
The MICRO-CARES prospective clinical database system was used to obtain data on all patients referred to the HIV/AIDS consultation-liaison psychiatry service in an infectious diseases hospital in Melbourne.
Three hundred and ninety-two inpatient referrals were made in the 2 years from 1993-1995: a referral rate of 16.7%. The most frequent reasons for referral were evaluation of coping problems (42%), assessment of possible depression (31%), and assessment of psychotropic medication (24.5%). The most common psychiatric diagnoses were mood disorders (36.5%), psychoactive substance use disorders (22.7%) and organic mental disorders (18.1%). Overall concordance of recognition of depression by the referring doctor and diagnosis of depression by the consultant psychiatrist was 79%; 20% false positive rate, 23% false negative rate.
Psychiatric comorbidity is common in patients with HIV/AIDS. Reasons for referral vary from those seen in other inpatient settings. Previously noted problems such as the misdiagnosis of psychiatric disorder and the mislabelling of the syndrome recognised by psychiatrists as depression were noted here.
概述联络精神科服务于艾滋病住院病房的工作情况，尤其是考察转诊医生对情绪及相关障碍的识别情况。
使用MICRO - CARES前瞻性临床数据库系统获取墨尔本一家传染病医院所有转诊至艾滋病咨询联络精神科服务的患者的数据。
在1993年至1995年的两年间，共收到392例住院患者转诊：转诊率为16.7%。最常见的转诊原因是应对问题评估（42%）、可能的抑郁症评估（31%）以及精神药物评估（24.5%）。最常见的精神科诊断是情绪障碍（36.5%）、精神活性物质使用障碍（22.7%）和器质性精神障碍（18.1%）。转诊医生对抑郁症的识别与精神科会诊医生对抑郁症的诊断总体一致性为79%；假阳性率为20%，假阴性率为23%。
艾滋病患者中精神科共病情况常见。转诊原因与其他住院环境中所见不同。此处注意到了先前指出的问题，如精神障碍的误诊以及精神科医生所认可的综合征被误称为抑郁症。
