Armstrong S C, Cozza K L, Watanabe K S
Willmar Regional Treatment Center, MN 56201, USA.
Psychosomatics. 1997 Sep-Oct;38(5):433-9. doi: 10.1016/S0033-3182(97)71420-8.
The authors examined the ability of nonpsychiatric house staff to accurately diagnose delirium at the time of consultation. Of 221 consultations over a 5-year period, 46% were misdiagnosed by the house staff. House staff on the general medicine wards and the nonintensive care unit environment did significantly better than those on the surgical wards and intensive care units. Age, gender, and race of the patient did not overall influence incorrect diagnoses; however, when a misdiagnosis occurred, women were more often given a diagnosis of a depressive disorder, whereas men were more often given a "no diagnosis" label. Finally, the consultees improved over an academic year in accurately identifying women as delirious, whereas no such learning curve existed for men.
作者们研究了非精神科住院医师在会诊时准确诊断谵妄的能力。在5年期间的221次会诊中，住院医师误诊率为46%。普通内科病房和非重症监护病房环境下的住院医师诊断表现显著优于外科病房和重症监护病房的住院医师。患者的年龄、性别和种族总体上并未影响错误诊断；然而，当出现误诊时，女性更常被诊断为抑郁症，而男性则更常被贴上“未确诊”的标签。最后，会诊医师在一学年中准确识别女性谵妄患者的能力有所提高，而男性则不存在这样的学习曲线。
