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不同年代上海某三甲综合医院医学心理门诊初诊患者诊治比较
A Study of Outpatients first visiting in the psychological clinic between different year in a General HospitaL in Shanghai

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DOI:
作者:
张晶璟 季建林 陈志青 许国勤 陆新茹
Zhang,Jingjing, Ji, Jianlin, Chen, Zhiqin, Xu,Guoq
作者单位:
上海交通大学附属第一人民医院 复旦大学附属中山医院
1. Dept. of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, she is now working in Shanghai First People’s Hospital 2. Coresponding Author, Dept. of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032
关键词:
综合医院精神卫生；医学心理咨询；抑郁；焦虑
general hospital psychiatry; counseling in psychological medicine; depression; anxiety
摘要:
【摘要】目的 比较20世纪90年代和21世纪初综合医院医学心理门诊初诊病例疾病构成和治疗随访等变迁。方法 选取1992年和2002年全年的某综合医院医学心理科门诊初诊病例，分别为178例和863例，比较这两年患者的疾病诊断与门诊随访状况。结果：1）10年间初诊病例增加5倍(178 vs 863)；2）综合医院医学心理门诊常见疾病诊断为：抑郁症（19.66% vs 35.34%,p＜0.01）、广泛性焦虑症(17.98% vs 15.64%,p＞0.05)、惊恐障碍(10.11% vs 11.47%,p＞0.05)和强迫症(10.67% vs 4.28%,p＜0.01)；3）精神病性障碍（7.30% vs 5.10%,p＞0.05）和双相情感障碍（1.69% vs 0.12%，p＜0.05）并不多见；4）5年门诊随访率10年间均偏低，无显著提高，如抑郁症（5.71% vs 10.49%，p＞0.05）、广泛性焦虑症（9.38% vs 15.56%，p＞0.05）、惊恐障碍（16.67% vs 19.19%，p＞0.05）和强迫症（15.79% vs 8.11%，p＞0.05）。结论：综合医院医学心理门诊服务需求不断增加，情感障碍与焦虑相关障碍的诊治患者最多见，但坚持门诊长期随访比例较低，双相情感障碍的诊断率偏低
Objective：To compare with the message of the disease construction ,therapy, and the diversity of the follow up rate in the all first visit cases in the psychological clinic of the general hospital in the nineties of twentith century and at the beginning of twenty-first century. Material and Method：We selected the all 178 cases of the first visit cases in the psychological clinic of one general hospital during the time from Jan First to Dec 31st in 1992, and also the all 863 cases of the first visit cases in the psychological clinic of the same hospital during the time from Jan First to Dec 31st in 2002. We collected the all clinical data and carried out data processing and statistical analysis to compare with the message of the disease construction ,therapy, and the diversity of the follow up rate. Result: 1) The number of first visit cases increased five times during these ten years(178 vs 863). 2)The first visit cases in the psychological clinic were more often diagnosed with depression(19.66% vs 35.34%,p<0.01), general anxiety disorder(17.98% vs 15.64%,p＞0.05), panic disorder(10.11% vs 11.47%,p＞0.05) and obsessive-compulsive disorder(10.67% vs 4.28%,p＜0.01). 3) There were few cases diagnosed with psychotic disorder(7.30% vs 5.10%,p＞0.05） and bipolar affective disorder(1.69% vs 0.12%，p＜0.05）.4）The follow up rate of the patients in the clinic at five years was generally low during these ten years, and was raised insignificantly. For instance, the follow up rate of depression was (5.71% vs 10.49%，p＞0.05）, general anxiety disorder was(9.38% vs 15.56%，p＞0.05）, panic disorder was(16.67% vs 19.19%，p＞0.05）, obsessive-compulsive disorder was(15.79% vs 8.11%，p＞0.05）.Conclusions: The demand of the service in psychological counseling clinic in general hospital has been increasing very quickly during these years. In our study, we can imply that affective disorder and anxiety accounted the extremely most cases, but the follow up rate of these patients in the clinic was poorly low. We also found the rate of diagnosis of bipolar affective disorder was partial low.

 

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