心理咨询门诊首诊189例的临床分析

目的 了解心理咨询门诊就诊对象一般情况、起病诱因、既往疾病史、诊断、治疗及男女间差异等,为心理咨询门诊工作提供指导.方法 整群抽取2002年5月21日～11月28日安徽省精神卫生中心心理咨询门诊所建的189份病历,对其首诊记录进行回顾性分析.结果 受教育程度为高中中专以上文化的被咨询者占65.54%,多于初中以下者(P＜0.01),差异有高度显著性.学生占相当的比例,占已知身份者中38.96%.男性以工作问题为疾病诱因的比例高于女性(P＜0.01),差异有高度显著性;男性恋爱问题为疾病诱因的比例高于女性(P＜0.05),差异有显著性,男性婚姻问题为诱因的比例低于女性(P＜0.01),差异有高度显著性;男性家庭问题为诱因的比例低于女性(P＜0.05),差异有显著性.被咨询者首诊时病程在10年以内的占96.76%;共有25.93%被咨询者既往经过治疗;既往慢性或严重疾病的患病率,男性高于女性(P＜0.01),差异有高度显著性;依据CCMD-3诊断为神经症者占被咨询者中38.10%,心境障碍占被咨询者中19.46%(P＜0.01),差异有高度显著性;分裂症、分裂样精神病、心境障碍、神经症总例数占建门诊病历的被咨询者中70.90%;治疗方案:138例(73.02%)皆心理治疗配合药物治疗.心理治疗用单纯心理疏导占121例(占138例中的87.68%).结论 心理工作者应更多关注学生心理健康,对男女心理咨询、干预应有不同侧重点,治疗中注意提高心理治疗质量.

Clinic Analysis of 189 New Cases in a Psycho-counseling Clinic

Objective To give some useful recommendations to a psycho-counseling clinic by studying the general status, diagnoses, treatments, and the differences between men and women about the first-visit outpatients in a psycho-counseling clinic. Methods We selected and analysised the entire 189 medical records which had been written in the psycho-counseling clinic in Hefei fourth people's hospital from May 21, 2002 to November 28, 2002. Results Students accounted for 38.96% of the visitors whose identities were known. The proportion of work difficulties as the male precipitating factors of mental disorder was significantly higher than that as the female precipitating factors (P<0.01) and so was the proportion of love frustrated (P<0.05); The proportion of the male marital crisis as precipitating factors of mental disorder was significantly lower than that as the female precipitating factors (P<0.01) and so was the proportion of family conflict (P<0.05). First treatment of 138 cases (73.02%) was psychotherapy with drug treatment, but the psychotherapy in 121 of them was simple and rough. Conclusion Psychological workers should pay more attention to students' mental health. Counselling interventions for women and men should have different emphases. Steps should be actively taken to improve psychotherapy for psycho-counseling more effective.