綜合病院 精神科諮問의 現況과 轉歸 一 서울大學校病院의 경북 ㅡ

Pattern & Outcomes of Psychiatric Consultation in a General Hospital

In an attempt to characterize psychiatric consultations in the areas of referral rates, psychiatric diagnoses, and consultees’ concordance with consultants’ recommendations in Korea, the medical records of 583 psychiatric consultations done from March 1, 1983 to Feb. 28, 1983 at a large university hospital were reviewed. Overall referral rate for psychiatric consultation was 1.5% for inpatients population, and the rates were 3 times greater from the medical services as compared w ith the surgical services. The frequency of current use of psychotropic drugs prior to consultations was 44%. Depression (23.5%) was the most common psychiatric diagnosis, followed by organic brain syndrome, hysteria, psychophysiological disorders and adjustment reactions, successively. Among various concordance rates with consultants’ recommendations, that of psychotropic drug recommendations was the highest (89.5%) and th at of diagnostic representation the lowest (44.6% ). Surgeons particularly showed the lowest concordance (24.4%) in diagnostic representation. Following numbers of variables were found to be significantly related to each category of concordances ------ 4 variables (current use of psychotropic drugs, specification of starting dosage, recommendation of same drugs as the consultee prescribed prior to the consultation, and concordance with further follow-up ward visit recommendations) to the concordance with phychotropic drug recommendations : 8 variables (previous psychiatric illness, current use of psychotropic drugs, psychiatric diagnosis by the consultee prior to the consultation, duration of hospitalization, concordance with psychotropic drug re commendations, and concordance w ith further follow-up ward visit recommendations) to the concordance with diagnostic representation : and 2 variables (current use of psychotropic drugs, and concordance w ith psychotropic drug recommendations).