Murphy H B
Can Med Assoc J. 1976 Sep 18;115(6):540-3.
In order to differentiate the neurotic patient who both needs and responds to psychiatric care from the majority of neurotic patients, who do not need this, carefully matched pairs of neurotic patients being treated at psychiatric and nonpsychiatric clinics in Montreal were followed up for 1 year. Improvement was substantial regardless of treatment, and the psychiatrically treated, on the whole, improved only slightly more than the others. However, one type of patient improved greatly under psychiatric care while improving almost not at all without it--introverts who considered themselves unhealthy but found life manageable, had avoided taking time off work or using anxiolytic drugs and appeared to handle their frustrations without repressing their irritation or losing self-control. It is suggested that it is mainly this type of neurotic that should receive specialist referral.
为了将既需要又对精神科治疗有反应的神经症患者与大多数不需要这种治疗的神经症患者区分开来，对在蒙特利尔的精神科和非精神科诊所接受治疗的精心匹配的成对神经症患者进行了为期1年的随访。无论接受何种治疗，病情都有显著改善，总体而言，接受精神科治疗的患者仅比其他患者稍有改善。然而，有一种患者在精神科治疗下改善显著，而在没有精神科治疗的情况下几乎没有改善——那些认为自己不健康但觉得生活还能应付的内向者，他们避免请假或使用抗焦虑药物，并且似乎能够处理自己的挫折感而不压抑愤怒或失去自控力。有人建议，主要是这类神经症患者应该接受专科转诊。
