皮膚科 外來에서의 精神科 諮問 連結의 經驗

Liaison Psychiatrist at Dermatology O utpatient Clinic

Seoul National Univ. Hospital established psychodermatology clinic at dermatology outpatient clinic as a psychiatry-dermatology liaison service in March, 1983 This paper illustrates 6 cases of 23 patients who visited this clinic for 6 months in 1983. Some clinical characteristics of these cases were observed and the problems which occured when this clinic was being organized as a kind of clinical model of psychiatric liaison service were discussed as follows: 1. The referred case to this clinic showed less initial dropouts than of referred cases directly to psychiatry out patient clinic. Also, the patient was more cooperative in case that he didn’t recognize the consultant as psychiatrist. 2. The causes of referral to this clinic seemed to be various. But most of the cases (especially 5 of 6 cases in this paper) were primarily psychiatric disorders and the cutaneous symptoms were merely a part of their symptom expression. 3. The preparation of the patients before referring to this clinic is necessary to prevent their early drop out. And more detailed descriptions of referred cases were required for effective therapeutic plan by the liaison psychiatrist. 4. Most of the patients expressed overt resistant feeling toward paying interview fee at this clinic, probably because their economic status was very low and this clinic belonged to dermatology outpatient clinic. 5. Considering limited experiences in this field and the emphasis on psychiatric approach itself, it was pointd out that the education and training Seoul National Univ. Hospital established psychodermatology clinic at dermatology outpatient clifor dermatologists as well as psychiatrists on consultation liaison psychiatry were necessary.