CAJ | 학술논문

目的：考察德国心身医学联络会诊的转诊服务中医学无法解释的躯体症状（M U PS ）患者的诊断情况与转诊来源。方法以德国某综合性大学附属医学中心2006～2010年向心身医学与心理治疗科转诊的8722例住院患者为研究对象，采用联络会诊－基本资料记录表（CL －BaDo ）收集数据。结果（1）由综合性医院的临床科室向心身科转诊的 MUPS 患者的躯体疾病诊断中，在一般症状（22.0％）、神经系统（20．9％）、骨骼和肌肉组织（7．1％）方面的诊断比例明显高于当前的心理症状组（Current Psychological Symptoms ，CPS ）的患者和应对方式问题组（Problems of Coping ）的患者；而M U PS患者在精神疾病的诊断中，在躯体形式障碍（17．9％）、伴有生理紊乱及躯体因素的行为综合征（8．1％）、成人人格和行为障碍（2．2％）和其他神经症性障碍方面（3．6％）的诊断比例高于CPS和Cop‐ing的患者。（2）转诊患者的来源方面，心身科联络会诊服务中患者的转诊科室比例从高到低依次为内科、外科、神经科和皮肤科，与 CPS 及 Coping 的患者相比，MUPS 患者主要的转诊科室为神经科。结论德国心身医学联络会诊转诊服务中的MUPS患者的诊断情况与转诊来源与CPS和Coping患者不同，具有独特性，对于我国综合性医院识别及转诊M U PS患者具有参考意义。
목적：고찰덕국심신의학련락회진적전진복무중의학무법해석적구체증상（M U PS ）환자적진단정황여전진래원。방법이덕국모종합성대학부속의학중심2006～2010년향심신의학여심리치료과전진적8722례주원환자위연구대상，채용련락회진－기본자료기록표（CL －BaDo ）수집수거。결과（1）유종합성의원적림상과실향심신과전진적 MUPS 환자적구체질병진단중，재일반증상（22.0％）、신경계통（20．9％）、골격화기육조직（7．1％）방면적진단비례명현고우당전적심리증상조（Current Psychological Symptoms ，CPS ）적환자화응대방식문제조（Problems of Coping ）적환자；이M U PS환자재정신질병적진단중，재구체형식장애（17．9％）、반유생리문란급구체인소적행위종합정（8．1％）、성인인격화행위장애（2．2％）화기타신경증성장애방면（3．6％）적진단비례고우CPS화Cop‐ing적환자。（2）전진환자적래원방면，심신과련락회진복무중환자적전진과실비례종고도저의차위내과、외과、신경과화피부과，여 CPS 급 Coping 적환자상비，MUPS 환자주요적전진과실위신경과。결론덕국심신의학련락회진전진복무중적MUPS환자적진단정황여전진래원여CPS화Coping환자불동，구유독특성，대우아국종합성의원식별급전진M U PS환자구유삼고의의。
Objective To assess the diagnosis and referral sources among patients with unex‐plained physical symptoms in consultation -liaison psychosomatics in Germany .current psychological symptoms(CPS)problems of coping .Methods A total number of 8 722 inpatients were referred between 2006 to 2010 to the department of psychosomatic medicine and psychotherapy in a University Hospital of Germany .These patients were investigated with CL -BaDo (a basis documentation form for C-L serv‐ice) .Results (1)As compared with the problems of coping group and current psychological symptoms (CPS) group ,the MUPS patients'rates of the physical problems like general system (22 .0% ) ,nervous system (20 .9% ) ,skeleton and muscle (7 .1% ) were significantly higher .The MUPS patients'rates of mental disorders like somatoform disorders (17 .9% ) ,behavioral syndromes associated with physiologi‐cal disturbances and physical factors (8 .1% ) ,disorders of adult personality and behavior (2 .2% ) and other neurotic disorders (3 .6% ) were also higher than the other two groups .(2)The main referral de‐partments were surgery (28 .7% ) ,internal medicine (42 .2% ) ,neurology (12 .6% ) and dermatology (5 .1% ) .Compared to the patients with CPS and the patients with coping problems ,the patients with MUPS were mainly referred from department of neurology (53 .9% ) .Conclusions There are differences of diagnosis and referral sources among patients with medically unexplained physical symptoms ,patients with CPS and patients with coping problems in consultation-liaison psychosomatics ,which is meaningful to the consultation-liaison service for MUPS patients in China .