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目的了解北京地区各级综合医院心理卫生服务状况。方法向北京18个区县的全部508家各级医院发放自制的《医院精神卫生情况调查表》,内容包括医院2001年提供心理卫生服务的种类、提供心理卫生服务人员的特征、心理卫生服务初诊患者数量及诊断、精神科药物的使用情况等。结果共有73%(373/508)的医院参加,其中综合医院占75%(325/436)。在325家综合医院中,171家(53%)提供1种或多种心理卫生服务;共有420名医务人员从事此项工作,但他们学历偏低,接受相关培训较少。61家设有心理门诊,其心理卫生初诊患者占全地区各类医院(包括精神专科医院)初诊患者的50%(47151/93891);其中90%(42578/47151)就诊于18家三级综合医院。综合医院有诊断分类资料的44441例心理卫生初诊患者中,43%为神经症,30%为抑郁症。所有接受调查医院售出的抗抑郁药总量的73%和氟西汀总量的97%是由103家综合医院售出的。结论应当重视综合医院的心理卫生服务,加强相关从业人员的培训,建立相应科室,尤其在一、二级医院。为监督综合医院心理卫生工作的发展趋势,提高质量及水平,应定期评估其心理卫生服务的种类和范围、诊断的准确性和治疗的合理性。
Objective To understand the status of mental health services in general hospitals at all levels in Beijing. Methods A self-made “Hospital Mental Health Questionnaire” was issued to all 508 hospitals in 18 districts and counties in Beijing. The content included types of mental health services provided by the hospital in 2001, features of mental health service providers, and initial diagnosis of mental health services. Number of patients and diagnosis, use of psychiatric drugs, etc. Results A total of 73% (373/508) hospitals participated, of which general hospitals accounted for 75% (325/436). Among the 325 general hospitals, 171 (53%) provided one or more mental health services; a total of 420 medical personnel engaged in this work, but they had low academic qualifications and received relatively less training. 61 have psychological clinics, and 50% (47151/93891) of newly diagnosed patients in various types of hospitals (including psychiatric hospitals) were diagnosed by mental health; 90% (42578/47151) of these patients were diagnosed in 18 tertiary levels. hospital. Of the 44 441 newly diagnosed mental health patients who had diagnostic classification data in general hospitals, 43% were neurosis and 30% were depression. Seventy-three percent of the total antidepressant drugs sold at the hospitals surveyed and 97% of the total fluoxetine were sold by 103 general hospitals. Conclusion It should pay attention to the mental health service of general hospitals, strengthen the training of relevant employees, and establish corresponding departments, especially the first and second grade hospitals. To supervise the development trend of mental health work in general hospitals and improve the quality and level, the types and scope of mental health services, the accuracy of diagnosis, and the rationality of treatment should be regularly evaluated.