80070189

open access

Version of Record

リエゾン イリョウ ニオケル セイシンカイ ノ ヤクワリ

The Role of Psychiatrists in Consultation-Liaison Psychiatry

Japanese (日本語)

神戸大学医療技術短期大学部紀要

8

25-31

神戸大学医療技術短期大学部

1992

2007-11-21

The basic approach of those who are connected with medicine should be, as has been pointed out repeatedly in the past, to grasp a patient in his or her totality rather than a disease. With the advancement in specialization of medicine, however, it has become very difficult for a single physician to treat a patient in unified manner. The authors will discuss the experience and role of consultation-liaison psychiatry applied to an in-patient suffering from systemic lupus erythematosus (SLE) who presented acute mental changes while she was treated in the pediatric department of the hospital. The patient was a girl of 14 years of age. She began to complain of insomnia and anxiety. The patient rapidly became delirious, complaining about the hallucination of sight and ideas of reference. The pediatrician in charge of the patient considered such conditions of the patient as psychogenic or endogenous psychosis. The parents of the patient attributed such conditions to the work of "something undefinable." Since there were some discrepancies between the pediatrician and the parents in understanding the mental changes of the patient, the relations between them became rather tense. The psychiatrist who was consulted by them diagnosed the state of the patient as the mental changes due to SLE. The psychiatrist explained the conditions of the patient to both the physician and the parents, in a manner acceptable to them, respectively, and started the treatment of the patient. The treatment by the psychiatric department was completed in about one month. When a psychiatrist is called in for consultation, there may exist, in many cases, some anxiety of discontent on the part of the medical staff or the patient or his or her family, and their relationships may be tense. It, therefore, is essential for the psychiatr-ist to be neutral to all the parties concerned and treat the patient in a manner that is acceptable to all of them.

紀要論文