Pathway to psychiatric care in Japan: A multicenter observational study

被引：30

作者：

Fujisawa D. ^{[1
,2
,3
]}

Hashimoto N. ^{[1
,4
]}

Masamune-Koizumi Y. ^{[1
,5
]}

Otsuka K. ^{[1
,6
]}

Tateno M. ^{[1
,7
]}

Okugawa G. ^{[1
,8
]}

Nakagawa A. ^{[1
,2
,3
]}

Sato R. ^{[1
,9
]}

Kikuchi T. ^{[1
,2
,3
]}

Tonai E. ^{[1
,10
]}

Yoshida K. ^{[1
,10
]}

Mori T. ^{[1
,11
]}

Takahashi H. ^{[1
,12
]}

Sato S. ^{[1
,13
]}

Igimi H. ^{[1
,14
]}

Waseda Y. ^{[1
,14
]}

Ueno T. ^{[1
,15
]}

Morokuma I. ^{[1
,16
]}

Takahashi K. ^{[1
,17
]}

Sartorius N. ^{[18
]}

机构：

[1] Japan Young Psychiatrists Organization Pathway Study Group, Shibuya-ku, Tokyo

[2] Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo

[3] Division of Psychiatry, Sakuragaoka Memorial Hospital, Tama-shi, Tokyo

[4] Department of Psychiatry, School of Medicine, Hokkaido University, Sapporo, North15

[5] Psychiatry Division, Kodama Hospital, Ishinomaki, Miyagi

[6] Department of Neuropsychiatry, Iwate Medical University, Morioka-shi, Iwate

[7] Division of Neuropsychiatry, Sapporo Medical University, Chuo-ku, Sapporo, Hokkaido, South 1

[8] Department of Neuropsychiatry, Kansai Medical School, Moriguchi-shi, Osaka

[9] Department of Psychiatry, Yokohama City University, Kanazawa-ku, Yokohama, Kanagawa

[10] Department of Psychiatry, School of Medicine, Fukuoka University, Jonan-ku, Fukuoka

[11] Division of Psychiatry, Takagi Hospital, Shimabara-shi, Nagasaki

[12] National Institute of Radiological Sciences, Inage-ku, Chiba

[13] Division of Psychiatry, Zikei Hospital, Okayama-shi, Okayama

[14] Department of Neuropsychiatry, Kurume University, School of Medicine, Oaza Buzen-shi, Fukuoka

[15] Department of Neuropsychiatry, Kyushu University, Graduate School of Medical Sciences, Higashi-ku, Fukuoka, 3-1-1, Maidashi

[16] Department of Psychiatry, Kochi University, School of Medicine, Nangoku-shi, Kochi

[17] Division of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo

[18] Department of Psychiatry, Geneva University, Department de Psychiatrie, 1205 Geneva, 16-18, Bd de St Georges

来源：

International Journal of Mental Health Systems | / 2卷 / 1期

关键词：

Depressive Symptom; Mental Health Professional; Somatic Symptom; Psychiatric Care; Private Practitioner;

D O I：

10.1186/1752-4458-2-14

中图分类号：

学科分类号：

摘要：

Background: This study examines pathways to psychiatric care in Japan using the same method as the collaborative study carried out in 1991 under the auspices of the World Health Organization. Methods: Thirteen psychiatric facilities in Japan were involved. Of the 228 patients who contacted psychiatric facilities with any psychiatric illness, eighty four visiting psychiatric facilities for the first time were enrolled. Pathways to psychiatric care, delays from the onset of illness to treatment prior to reaching psychiatrists were surveyed. Results: Thirty three patients (39.4%) directly accessed mental health professionals, 32 patients (38.1%) reached them via general hospital, and 13 patients (15.5%) via private practitioners. The patients who consulted mental health professionals as their first carers took a longer time before consulting psychiatrists than the patients who consulted non-mental health professionals as their first carers. The patients who presented somatic symptoms as their main problem experienced longer delay from the onset of illness to psychiatric care than the patients who complained about depressive or anxiety symptoms. Prior to the visit to mental health professionals, patients were rarely informed about their diagnosis and did not receive appropriate treatments from their physicians. Private practitioners were more likely to prescribe psychotropics than physicians in general hospitals, but were less likely to inform their patients of their diagnosis. Conclusion: This first pathway to psychiatric care study in Japan demonstrated that referral pathway in Japan heavily relies on medical resources. The study indicates possible fields and gives indications, underlining the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders presenting with somatic and depressive symptoms in the general health care system and by private practitioners. © 2008 Fujisawa et al; licensee BioMed Central Ltd.

引用

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