소위 종합진찰’ 환자의 정신과적 특성에 관한 예비연구

A Preliminary Study about Psychiatric Characteristics of Patients Admitted for General-Health Evaluation

This study was performed to investigate psychiatric characteristics of patients who were admitted for general-health evaluation. Subjects were 111 patients who were admitted to Chonnam National University Hospital from May, 1989 to July, 1990. They were diagnosed with DSM-III-R, and evaluated with the Korean version of Symptom-Checklist-90-Revised (SCL-90-R). Author analyzed the demographic characteristics, the result of medical evaluation, and the prevalence of psychiatric disorder. The subscale of SCL-90-R were compared between subjects with psychiatric disorder and those without psychiatric disorder. And discriminant analysis was carried out to examine the discriminating power o f SCL-90-R as a screening test for these patients. Results of this study were as follows ; 1) The number of male subjects was 66(59.5%) and that of female was 45(40.5% ). The mean age of subjects was 44.9士 12.7(from 19 to 80 years old). 2) The number of subjects who had past medical or surgical history was 57(51.4% ). 3) The number of subjects who had visited psychiatric clinic was 7(6.3% ). 4) After medical evaluation, nearly one-third of subjects(31.5%) were found to have no medical illness. Among subjects who had abnormalities by medical evaluation, nearly half of subjects(52%) had no subjective symptom. 5) After psychiatric evaluation, 56.8 % of subjects were diagnosed as having obvious psychiatric disorders, such as somatoform disorder(37.9%), depressive disorder(9.0%), anxiety disorder(8.nO and schizophrenic disorder(l.8% ). The female subjects, younger subjects, and subjcets who had no medical diagnosis had tendency to have psychiatric disorders. 6) W hen the sub scale scores of SCL-90-R were compared between subjects with psychiatric diagnosis and those without psychiatric diagnosis, all sub scale scores except paranoid subscale were statistically higher in subjects with psychiatric diagnosis. 7) After discriminant analysis, the correctively discriminated percentage among subjects with psychiatric diagnosis was 63.5%, and that among subjects without diagnosis was 19.2%. The total correctively discriminated percentage was 70.3 %. In summary, these results suggest that relatively large numbers of subjects who were admitted for general health evaluation have psychiatric illnesses and that SCL-90-R can be used as psychiatric screening test for these subjects.