背景:根据患者的文化和种族背景,精神疾病的频率和症状有所不同。这可能使诊断和治疗患者具有全球挑战性。在巴基斯坦,大多数精神病患者报告多个躯体疾病。我们的目标是调查这些投诉的原因,确定常见的精神疾病,并分析其在临床实践中的各种表现。我们还旨在确定提高患者护理质量的方法。
方法:我们利用预定的表格从门诊就诊的231名患者的样本中收集和组织数据。由于我们的机构没有精神科,因此未将住院患者纳入本研究。对患者过去的医疗和精神病记录进行了彻底检查,并提取了相关信息。研究人群中最常见的精神疾病是根据国际疾病分类诊断的,第十次修订(ICD-10)诊断标准。
结果:在这项研究中,我们检查了231个样本量,以确定男性和女性中最常见的疾病(ICD-10).在男性中,最常见的疾病是混合性焦虑和抑郁(MAD),抑郁症,广泛性焦虑症(GAD),双相情感障碍(BPAD),社交恐惧症,强迫症(OCD)。雌性,另一方面,表现出更多的抑郁症,GAD,焦虑和抑郁混合,转换或分离障碍,强迫症,和恐慌症。头痛是最常见的症状,61.9%的参与者经历过,接着是嗜睡,四肢疼痛,心悸,食欲不振,胃灼热或酸度,沉重的头,肩痛,腹胀,头晕,胸痛,潮热或颤抖,还有便秘.同时,四分之一的男性没有抱怨任何躯体症状,与10%的女性相比。此外,7.3%的女性报告超过六种躯体症状,与男性的5.7%相比。当谈到治疗偏好时,73.6%的参与者更喜欢药物而不是心理治疗以及两者的组合。统计产品和服务解决方案(SPSS)统计版本22(IBMSPSSStatistics,Armonk,NY,USA)用于进行独立性的卡方检验,以分析获得的数据。对于定量数据的事后分析(即,参与者报告的躯体症状数量),应用单向方差分析(ANOVA),其次是Tukey的诚实显著性差异(HSD)检验。
结论:这是针对该人群和地区的首次此类综合研究。它强调临床医生应该意识到该人群中躯体症状和精神病表现的多样性。这种意识可以改善临床实践并减轻卫生服务的负担。
BACKGROUND: Psychiatric disorders differ in frequency and symptoms based on the cultural and ethnic background of patients. This can make diagnosing and treating patients challenging globally. In Pakistan, most psychiatric patients report multiple somatic complaints. Our goal was to investigate the causes of these complaints, identify common psychiatric conditions, and analyze their various manifestations in clinical practice. We also aimed to identify ways to improve the quality of care provided to our patients.
METHODS: We collected and organized data by utilizing predetermined tables from a sample of 231 patients who visited the outpatient clinics. Inpatients were not included in this
study because of the absence of a psychiatric unit at our facility. Patients\' past medical and psychiatric records were thoroughly examined, and pertinent information was extracted. The most common psychiatric disorders within the studied population were diagnosed based on the International Classification of Diseases, Tenth Revision (ICD-10) diagnostic criteria.
RESULTS: In this
study, a sample size of 231 was examined to determine the most common diseases (ICD-10) in males and females. In males, the most prevalent diseases were mixed anxiety and depression (MAD), depression, generalized anxiety disorder (GAD), bipolar affective disorder (BPAD), social phobia, and obsessive-compulsive disorder (OCD). Females, on the other hand, presented more with depression, GAD, mixed anxiety and depression, conversion or dissociative disorder, OCD, and panic attacks. Headaches were the most frequently reported symptom, experienced by 61.9% the of participants, followed by lethargy, extremity pains, palpitations, loss of appetite, heartburn or acidity, heaviness on the head, shoulder pains, bloating, dizziness, chest pains, hot flashes or shivering, and constipation. Meanwhile, a quarter of the males did not complain of any somatic symptoms, compared to 10% of the females. Additionally, 7.3% of females reported more than six somatic symptoms, compared to 5.7% of males. When it came to treatment preferences, 73.6% of the participants preferred medication over psychotherapy and over a combination of both. The Statistical Product and Service Solutions (SPSS) Statistics version 22 (IBM SPSS Statistics, Armonk, NY, USA) was used to conduct a chi-square test of independence to analyze the obtained data. For post hoc analysis of quantitative data (i.e., the number of somatic symptoms reported by participants), one-way analysis of variance (ANOVA) was applied, followed by Tukey\'s honestly significant difference (HSD) test.
CONCLUSIONS: This is the first comprehensive
study of its kind for this population and region. It emphasizes that clinicians should be aware of the variety of somatic symptoms and psychiatric presentations among this population. Such awareness can improve clinical practices and reduce the burden on health services.