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KMID : 0378019900330020059
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New Medical Journal
1990 Volume.33 No. 2 p.59 ~ p.68
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A Study on the Psychiatric Consultation in a General Hospital
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Abstract
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This is a fundamental study concerning the role of family physicians who are coordinators and provide continuing care through the consideration on the psychiatric consultation in a general hospital (Kosin Medical Center).
From Jan 1988 to May 1989, 179 inpatients had been consulted to the psychiatric department from other departments, but 40 cases were excluded
in this study because their medical records were incomplete, after reviewing their consultation papers and medical records including doctor´s order papers, discharge summary, we obtained the result as follows.
1. The consultation rate of total inpatients was 0.8%. Male patients were 63(45.4%) and Female were 76(54.7%). Age distribution revealed that over the half (54.7%) was 4th-6th decades, and the host frequent age group in the male was 4th decade (25.4%), in the female was 6th decade (23. 7%).
2. The order of the departments which tried psychiatric consultation was internal medicine (40.3%), neurosurgery (20.1 %) , pediatrics (12.9%) , orthopedic surgery ( 7.2%) etc.
3. According to the cause of the consultation cases for psychiatric diagnosis of the patient with physical diagnosis (51.8%), cases with somatic symptoms and normal laboratory da´a(3 0.2%), cases who had previous psychiatric history (13.7%) were ordered.
4. About the somatic symptoms on consultation, cases who complained only head and CNS problems were most frequent (18.0%), and the second most frequent symptoms were gastrointestinal problems (16.5%). And case that two of above were combined, was 12.2%, about the psychiatric symptoms on consultation, only insomnia, insomnia with emotional problems, only emotional ones were 23.7%, 10.1%, 7.2%, respectively.
5. Among the psychiatric diagnoses, affective disorder occupied 43 cases (30.9%), most frequently, including dysthymic disorder (29 cases, 20.9%), major depression (10 cases, 7.2%), atypical depression (4 cases, 2.9%), Following it, somatoform disorder was 24 ones (17.E%), and OMD was 13 ones (9.4%).
6. About the use of drugs by nonpsychiatric physicians before the consultation, they didn´t use any drug for complaints pertaining to consultation in 61.2%, and used antianxiety drugs in 28.8%, antidepressant in 3.6%. About drugs recommended by psychiatric physicians, they recommended no medication in 21.6%, antianxiety drugs in 22.3%, ant psychotic drugs in 12.5%, and antidepressant in 7.2%, and antianxiety drugs combined with antidepressant in 32.4%.
7. Cases recommended to refer to the psychiatric department were 58(41.7%), but cases referred really were 31(22.3%), And only 21.6% of the total cases visited to the OPD of the psychiatry one or more times.
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KEYWORD
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