국군O O 병원 정신과 입원환자의 추적조사

Follow-up of Psychiatric Inpatients in OO Armed Forces Fidd Hospital

Objects : This study was aim ed at 1) the com parison between rejoin and C D groups and 2) the rate o f diagnostic agreement and evaluation on discharge between psychiatrists in the army hospitals. Method • This study was designed to follow up 150 inpatients in the departm ent o f Neuropsychiatry o f 00 Arm ed Forces Field Hospital ( abb reviated as field hospital) or evacuated via that field hospital from July 1，1991 to December 31，1992. They were soldiers below the rank of sergeant first class. Results : Am ong 150 patients, 99 soldiers rejoined their unit after proper treatment(abbreviated as rejoin group) and 51 patients were discharged from the service(abbreviated as C D group, compassionate discharge group) in field hospital, evacuation hospital or general hospitals. The rate of onset of psychiatric illness before enlistment was 58.8% in CD group. In rejoin group, 75.7% had the onset of psychiatric illness before private first class. In diagnosis, adjustment reaction and conversion disorder patients were 73.7% in rejoin group. In CD group, almost all were epileptics, m ajor depressions, personality disorders, or mental retardations. Average duration of hospitalization was 76.9± 54.6 days in all subjects. There was a statistically significant difference, especially for general h o sp ital(F = 32.6176, df= 2 , p 〈.01). Evaluation on discharge was as follows : 1) 34.0% were discharged from the service because o f psychiatric illness. 2) 27.3%were expected to serve without further psychiatric symptoms or problems. 3) Even though it is not fully resolved, 26.7% were expected to serve. The rate of diagnostic agreement between doctors in field-evacuation-general hospital was 84.2% Conclusion : We have to keep in mind that 58.8 % of CD group began to show their psychiatric symptoms and 49.0% had psychiatric problem sprior to enlistm ent The critical period for the rejoin group was from the beginning of private to private first class. The average duration of hospitalization in the army was longer than that of civilian hospitals. One of themain reasons was due to the characteristics of the evacuation system in the army. With due regard to the evluation on discharge and the rate of diagnostic agreement, army doctors, especially psychiatrists, were excellent at diagnosing and treating the psychiatric patients.