Wancata J, Benda N, Hajji M
Universitätsklinik für Psychiatrie, Wien, Osterreich.
Wien Klin Wochenschr. 1998 Sep 18;110(17):597-603.
While several surveys have shown that psychiatric disorders are common in non-psychiatric hospital departments, information on the course of psychiatric morbidity during the hospital stay is still lacking. Therefore, in two medical hospital departments in Austria we investigated the course of illness in 265 patients staying in the hospital for more than four weeks. Patients were interviewed using the Clinical Interview Schedule. At admission, prevalence of all psychiatric disorders was 46.0%. During the four weeks after admission, mentally well were discharged from hospital more frequently than mentally ill. Among those staying in the hospital after four weeks, prevalence was 51.4%. In the intervening period, the incidence (9.5%) was slightly lower than the rate of remission (12.4%). At both assessments, organic mental illness was the most frequent diagnosis followed by neurotic and adjustment disorders. Thus, in spite of the slightly higher rate of remission than incidence, the overall psychiatric prevalence increased during the first four weeks after admission because of the earlier discharges of the mentally well. In conclusion, our results show that point-prevalence surveys not regarding disease course give an incomplete impression of psychiatric morbidity in non-psychiatric hospital departments.
虽然多项调查显示精神障碍在非精神科医院科室中很常见，但关于住院期间精神疾病发病过程的信息仍然匮乏。因此，在奥地利的两个内科医院科室，我们对265名住院超过四周的患者的疾病过程进行了调查。使用临床访谈问卷对患者进行访谈。入院时，所有精神障碍的患病率为46.0%。入院后的四周内，精神状态良好的患者比精神疾病患者更频繁地出院。在四周后仍住院的患者中，患病率为51.4%。在此期间，发病率（9.5%）略低于缓解率（12.4%）。在两次评估中，器质性精神疾病是最常见的诊断，其次是神经症和适应障碍。因此，尽管缓解率略高于发病率，但由于精神状态良好的患者较早出院，入院后头四周内总体精神疾病患病率仍有所上升。总之，我们的结果表明，不考虑疾病过程的现患率调查会给非精神科医院科室的精神疾病发病率留下不完整的印象。
