정신과에 자문의뢰된 내과입원환자들의 질병 행동

Illness Behavior of Medical Inpatients Referred for Psychiatric Consultation

Structured interview was done to make a comparision regarding illness behavior between consultation patients and non-consultation patients. The findings are as follow • 1) Consultation patients more often recalled having received notice of diagnosis than nonconsultation patients. 2) With regard to concordance of diagnosis, consultation patients were significantly lower than nonconsultation patients. 3) Consultation patients recalled having been admitted to more general hospitals than nonconsultation patients. 4) Consultation patients reported more anxiety and irritability than nonconsultation patients. The -former patients had more psychosomatic disorders than the latter ones. 5) Consultation patients more often recalled being told there was nothing at all. They were also more likely to recall an explanation that their illness was due to either combination of somatic and psychological factors or psychological ones. 6) Consultation patients were less likely to affirm the presence of somatic disease, but more likely to affirm the presence of psychological disorder. They were also more likely to believe their illnesses were caused by psychological factors. 7) In consultation patients, male, older age, higher education, lower income, presence of occupation, and absence of psychological stressors at the onset of illness were found to be the variables by which their belief in somatic disease and/or somatic causes was more likely to be influenced. The above results suggest that at first, consultation patients rejected the explanation that their illness was due to psychological causes, but that over time，they more often accepted such explanation. Thus, in order to treat medical inpatients with psychiatric problems more effectively，psychiatrists, intervention should be considered following internists’ appropriate explanation about illness.