全科医生-心理治疗师联合团队模式探讨： 以躯体不适为主诉的心理障碍案例报道

Abstract

以躯体不适为主诉的心理障碍患者常就诊于综合医院消化、妇科、神经内科等非精神心理专科，正确识别率低，以致病情延误，医疗负担加重。本文报道了１例以头晕、胸闷、气短为主诉的心理障碍患者全科医生与心理治疗师共同照顾过程，探讨了全科医生-心理治疗师联合团队模式在照顾以躯体不适为主诉的心理障碍患者上的优势：尽早正确识别、提高心理治疗实际利用率、更好协助促进干预效果。该模式是综合医院心理卫生服务模式的一次创新探索，为日后构建切实可行的综合医院新型心理卫生服务模式提供启发与思路.

Psychological disorder patients with somatic symptoms often present to non-mental health departments in a general hospital such as gastroenterology，gynecology and neurology for help with different physical complaints.However，unsatisfied level of mental health care of non-mental health professionals may result in low accuracy in recognizing psychological problems early，which may lead to a delayed diagnosis of the real problems and cause an increase in medical burden.We reported a case of psychological disorder presenting with dizziness，chest discomfort and dyspnea treated with general practitioner-psychotherapist team-based care，and summarized that this kind of collaborative team care may help to recognize psychological problems accurately and early，and improve the actual utilization rate of psychotherapy services as well as the treatment outcome.This kind of care is a new exploration of the delivery of psychotherapy services by a general hospital，which may provide insights into future development of psychotherapy services delivery patterns feasible for such hospitals.