정신과 의뢰에 대한 임상적 연구

A CLINICAL STUDY ON PSYCHIATRIC CONSULTATION

A clinical study was done with 307 inpatients (1.84% in all patients) referred for psychiatric consultation in Yonsei Medical Center for last one year. Referral was common in 20—49 year age group and male to female ratio was almost equal. Most of referrals came from the department of internal medicine (table 1). The reasons of referrals were general evaluation and managment of the patients. Primary diagnosis before consulation were mostly physical ones, and drug intoxication due to suicidal attempt, G-I disorders, convulsive disorders, heart disorders and head traumas were the major problems. But psychiatrist made psychiatric diagnosis in 95.6%, and depre-ssive neurosis, hysterical neurosis, involutional melancholia and psychosomatic disorders were most common (table 2), and thought physical diseases concurrent with psychiatric diseases in 66- 3% (table 3). In general, depression was found to be an important and most common psychiatric problem complicated with physical diseases. Psychiatric problems were commonly correlated with the disorders of G-I, nervous and cardiovascular systems and especially the depression with G-I disorders. The data appeared to reflect the general tendency of physicians not to accept the opinions of psychiatrists on the diagnosis and management except psychotropic medication. Psychiatric consultation liaison service is important in collaboration between psychiatry and medicine in comprehensive patient care and teaching the psychosomatic aspects of the diseases.