Clinical Characteristics and Referral Patterns of Outpatients Visiting a Japanese Psychosomatic Medicine Clinic
Clinical Characteristics and Referral Patterns of Outpatients Visiting a Japanese Psychosomatic Medicine Clinic
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DOI：
10.1007/s12529-015-9520-0
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发表时间：
2016-10-01
影响因子：
2.7
通讯作者：
Takeuchi, Takeaki
中科院分区：
文献类型：
--
作者：
Nakao, Mutsuhiro;Takeuchi, Takeaki
背景 各国心身医学的定义并不一致。 目的 本研究的目的是阐明日本心身医学会发布的心身疾病定义对大学医院不同类型转诊的适用性。 方法 样本由 1067 名到心身诊所就诊的门诊患者组成。参与者根据《诊断和统计手册》第四版文本修订版完成临床访谈后，填写问卷以评估躯体化、抑郁、焦虑和社会心理压力的程度。所有受试者被分为心身组和非心身组，非心身组进一步分为三个附加组：抑郁组、焦虑组和其他组。结果总共有 398 名受试者（37%）被分为心身组。院内转诊的心身群体比例为 46%，院外转诊的心身群体比例为 37%，未经医生转诊的心身群体比例为 28%。至于非心身组，269 人（25%）被分入抑郁组，229 人（22%）被分入焦虑组，171 人（16%）被分入另一组。心身组的成员资格与年龄和体感放大的严重程度呈正相关（均 p < 0.05），但与抑郁和焦虑的严重程度以及未转诊的分类呈负相关（均 p < 0.05）。结论 虽然精神疾病（包括抑郁症和焦虑症）患者在日本心身诊所常见，但被诊断为心身疾病的患者往往是在不到 10 天内就被医生转诊的。医院。心身医学的概念需要进一步发展，以帮助临床医生和患者。
Background The definition of psychosomatic medicine is not consistent across countries.Purpose The study purpose was to clarify the applicability of the definition of psychosomatic illness issued by the Japanese Society of Psychosomatic Medicine to different types of referral in a university hospital.Methods The sample consisted of 1067 outpatients visiting a psychosomatic clinic. Participants completed questionnaires to assess degrees of somatization, depression, anxiety, and psychosocial stress after completing clinical interviews based on the Diagnostic and Statistical Manual, Fourth Edition, Text Revision. All subjects were classified into psychosomatic and non-psychosomatic groups, and the non-psychosomatic group was further divided into three additional groups: depression, anxiety, and other.Results In total, 398 (37 %) of the subjects were placed in the psychosomatic group. The percentage of the psychosomatic group was 46 % in those referred within the hospital, 37 % in those referred outside the hospital, and 28 % in those without referral from physicians. Concerning the non-psychosomatic group, 269 (25 %) were placed in the depression group, 229 (22 %) in the anxiety group, and 171 (16 %) in the other group. Membership in the psychosomatic group was positively associated with age and the severity of somatosensory amplification (both p < 0.05), but negatively associated with the severity of depression and anxiety as well as the classification of non-referral (all p < 0.05).Conclusions Although patients with psychiatric disorders, including depressive and anxiety disorders, are frequently seen in the Japanese psychosomatic clinic, patients who are diagnosed with psychosomatic illnesses tend to have been referred by physicians within the hospital. The concept of psychosomatic medicine needs to be further developed to assist both clinical practitioners and patients.