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題名 | 兒童精神科照會之描述性研究=Child Psychiatric Consultation in a General Hospital |
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作者 | 翁菁菁; 宋維村; 丘彥南; 高淑芬; 蔡文哲; | 書刊名 | 臺灣精神醫學 |
卷期 | 13:1 1999.03[民88.03] |
頁次 | 頁35-43 |
分類號 | 415.9517 |
關鍵詞 | 兒童精神科照會; 照會率; 照會原因; 精神疾病診斷; Child psychiatric consultation; Referral rate; Reasons for referral; Psychiatric diagnosis; |
語文 | 中文(Chinese) |
中文摘要 | 目的:了解住院病人照會兒童精神科的主要原因、照會率、精神疾病診晰、精神 科處置,並探討照會原因與精神疾病診斷之相關性。 方法:採取病歷回溯法,將 1992 年 7 月至 1997 年 6 月臺大醫院照會兒童精神科的 357 位住院病人之病歷,依預先設計的格式,摘取相關資料,進行描述性分析。 結果:研究期間臺大啟院年滿一歲至十八歲的住院病人照會率為 1.64%;以小兒科病房住院 病人的照曾率最高 (3.59%)。照會的主要原因歸納為身體症狀的鑑別診斷 (26.3%)、行為問 題 (22.1%)、器官移植前之評估 (21.9%)、智能發展評估 (15.7%)、 情緒問題 (14.0%) 等 五大類。 照會病人中 67.2% 有精神疾病診斷。依據 ICD-10 診斷,最常見的是精神官能性 、 壓力相關性與擬身體障礙性疾病 (24.7%), 其次是器質性精神疾病 (11.1%)、智能不足 (9.2%) 及特發於兒童期或少年期之精神與行為障礙 (9.2%)。而無精神疾病診斷之病人大多 是因器官移植前評估照會的。除去器官移植前評估照會的個案後,在照會原因與精神疾病該 斯之間的關係上,因身體症狀的鑑別診晰而照會的個案中,以非器質性精神疾病相關的診斯 較多;因行為問題而照會的個案申,器質性精神疾病與非器質性精神疾病相關的診晰則差別 不大;因情緒問題而照曾的個案中,以非器質性精神疾病相關的診斷較多;智能發展評估而 照曾的個案中, 以器質性精神疾病相關的診斷較多。 精神科之處置以給子諮商建議為最多 (83.9%),1.7% 轉至精神科病房幾絞治療,17.1% 的照會病人於出院後轉介到兒童精神科門 診追蹤。 結論:臺大醫院近五年來住院病人兒童精神科的照會率與外國相關文獻類似,但後續追蹤治 療的比率則較低。不同的照會原因,其精神疾病診斷的分布亦有差異存在。 |
英文摘要 | Objective: This study sought to determine the child psychiatric consultation rate, reasons for referral, psychiatric diagnoses, and the recommendations for psychiatric treatment of child and adolescent inpatients in National Taiwan University Hospital. Methods: The medical records from 357 psychiatric consultations made from July 1, 1992 through June 30,1997 were reviewed. Psychiatric diagnoses were made according to ICD-10 criteria. Results: The referral rate was 1.64%. The majority of consultations were requested by the pediatrics (80.6% of all consultations, referral rate: 3.59%). The reasons for referral included differential diagnosis of somatic complaints (26.3%), behavioral problems (22.1%), pretransplantation assessment (21.9%), developmental/intellectual assessment (15.7%)and emotional problems (14.0%). There were 236 (67.2%) which led to the diagnosis of a psychiatric disorder. The most common psychiatric diagnosis was neurotic, stress-re-lated, and somatoform disorders (24.7%), followed by organic mental disorders (11.1%), mental retardation (9.2%) and behavioral and emotional disorders with onset usually occurring in childhood and adolescence (9.2%). The majority of consultations which found no psychiatric disorder were with inpatients referred for pretransplantation assessment. Organic related mental disorders were more in the group of developmental/intellectual assessment than nonorganic related mental disorders. Non-organic related mental disorders were more in the groups of emotional problems and differentiation of somatic com- plaints. The most common psychiatric recommendation was counseling (83.9%). The rate of transfer to psychiatric ward for further management was 1.7% and the rate of fol-low-up at a child psychiatric outpatient clinic after discharge was 17.1%. Conclusion: The referral rate among all child and adolescent inpatients in this series was 1.64%. This is similar to referral rates reported from studies outside of Taiwan. However, the rate of psychiatric follow-up was lower in this series than in studies of other populations. The most common psychiatric diagnosis was neurotic, stress-related, and somatoform disorders. (Full Text in Chinese) |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。