내과입원 중 정신과에 자문의뢰된 신경증 환자에 대한 임상적 고찰

A Clinical Study of Consulted Medical Inpatients with Neurosis

We compared the clinical characteristics of two groups, 108 consulted medical inpatients with neurosis and 138 psychiatric inpatients with neurosis, during the period January 1, 1989 to December 31，1991 at Seoul Red Cross Hospital. The results show various clinical differences between two groups. The results were as follows 1) In the mean age, medical inpatients were older than psychiatric inpatients. Especially, in the aged patients over 60 years, medical inpatients outnumbered psychiatric inpatients. In the case of sex, female patients outnumbered male patients. In the educational level, both group h ad low educational level. 2) As to the symptom duration, medical inpatients usually had duration under one month, psychiatric inpatients were com m on over one year. 3) Most of the patients admitted via outpatient department medical inpatients outnumbered psychiatric inpatients in the case of via emergency room. 4) The mean duration of hospitalization of medical inpatients were significantly longer than that of psychiatric inpatients. 5) The main organic diagnosis in medical inpatient group was gastrointestinal disorder. After psychiatric consultation, the number of cases with psychiatric diagnosis increased significantly in medical inpatient group. 6) The main psychiatric diagnosis in both group was depressive disorder, followed by somatoform disorder and anxiety disorder. Somatization disorder was more common in medical in patient group than in psychiatric inpatient group. While conversion disorder was more frequent in psychiatric inpatient group. 7) Medical inpatients had more physical complaints than those of psychiatric inpatients. The main physical symptom in medical inpatient group was gastrointestinal symptom. But the main physical symptom in psychiatric inpatient group was head and central nervous system symptom. 8) The major reason for psychiatric consultation was subjective physical symptoms which were not related to conformed medical illness. 9) Before psychiatric consultation, 78.7 % of medical inpatients were prescribed psychotropic drugs. 10) As to the concordance rates with the consultant’ s recommandation, psychotropic drug(93. 2% ), diagnostic procedure(lO.0%), and diagnostic presentation(65.7%) were relatively high, but those of transfer(50%) and outpatient department follow-up(43.8%) were relatively low