정신과 외래환자의 의료추구 행태에 관한 연구

A Study of Pattern of Help-Seeking Behavior Among Psychiatric Out-Patients

This study was conducted to investigate the general characteristics of help-seeking behavior among psychiatric out-patients who visited a university hospital and was diagnosed as neurotic. The purpose of this study was to understand the psychiatric patients in the context of culture and psychiatry. The data was collected through semistructured interview of 137 psychiatric outpatients. The results are as follows; 1) The category of initial problems most frequently cited by patients were somatic problems ( 8 8 ^ ) while about 67% and 14% of patients complained of psychological problems and preceding contexts(e.g., interpersonal conflict, poor performance, accident respectively). The psychiatrist noted affective symptoms in 89%, cognitive-perceptual symptoms in 64 %, behavioral symptoms in 33% and somatic symptoms in 88% of subjects. The psychiatrist identified affective symptoms much more frequently than the patients themselves reported. Regarding somatic symptoms, there was no difference between the psychiatrist’ s report and patients’ report. 2) The average number of somatic problems cited by patients was twice more than that of psychological problems. 3) Patients most often (42%) consulted professionals in general medicine initially. 4) The long delay between the onset of the initial problem and the present psychiatric consultation was noticed. About 18% of patients had one to three years’ lag and another 28% had over three years lag. 5) Advice to visit psychiatrist was most frequently came from western doctors(34%). 6) Most of the patients(47%) resorted to self-directed psychological means as their initial way of coping. 7) No sidgnificant relationship was found between various socio demographic characteristics and diagnostic categories, or patterns of help-seeking behavior. 8) Most patients utilized multiple resources during the course of their help-seeking( general medicine 71%，traditional medicine 48%, drug store 41%, religion 13%) and they seemed to have only superficial conceptualization about their illness.