精神疾患と身体疾患の合併―臨床的·医療経済的インパクトならびにその治療システム
「はじめに」現在の医療体系は, デカルトの説いたCartesian dualism, “mind(精神)とbody(身体)はinteractionやcommunicationはほとんど認められない”, を基本としており, “(一般診療科と精神科は)異なった独立した場所で, 異なった医師が診療を行う”制度になっている1. しかし, 身体疾患に罹患すると精神疾患を合併することが多く, 臨床的, 医療経済的にも両者の治療を同時に行うことの重要性が示されており, 効果的・効率的な治療システムを構築していく必要がある. 「身体疾患現場での精神疾患有病率」表1に精神疾患の有病率のまとめを示す2. 頻繁にみ...
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Published in | 日本医科大学医学会雑誌 Vol. 4; no. 4; pp. 175 - 180 |
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Format | Journal Article |
Language | Japanese |
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日本医科大学医学会
2008
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Abstract | 「はじめに」現在の医療体系は, デカルトの説いたCartesian dualism, “mind(精神)とbody(身体)はinteractionやcommunicationはほとんど認められない”, を基本としており, “(一般診療科と精神科は)異なった独立した場所で, 異なった医師が診療を行う”制度になっている1. しかし, 身体疾患に罹患すると精神疾患を合併することが多く, 臨床的, 医療経済的にも両者の治療を同時に行うことの重要性が示されており, 効果的・効率的な治療システムを構築していく必要がある. 「身体疾患現場での精神疾患有病率」表1に精神疾患の有病率のまとめを示す2. 頻繁にみられる精神疾患をみてみると, 健康人と比べて身体疾患罹患患者で大うつ病は2~3倍, パニック障害や身体化障害で10~20倍, 物質依存では3~5倍の頻度で認められる. せん妄は健康人では認められることはほとんどなく, 入院患者の約15~30%に認められる. |
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AbstractList | 「はじめに」現在の医療体系は, デカルトの説いたCartesian dualism, “mind(精神)とbody(身体)はinteractionやcommunicationはほとんど認められない”, を基本としており, “(一般診療科と精神科は)異なった独立した場所で, 異なった医師が診療を行う”制度になっている1. しかし, 身体疾患に罹患すると精神疾患を合併することが多く, 臨床的, 医療経済的にも両者の治療を同時に行うことの重要性が示されており, 効果的・効率的な治療システムを構築していく必要がある. 「身体疾患現場での精神疾患有病率」表1に精神疾患の有病率のまとめを示す2. 頻繁にみられる精神疾患をみてみると, 健康人と比べて身体疾患罹患患者で大うつ病は2~3倍, パニック障害や身体化障害で10~20倍, 物質依存では3~5倍の頻度で認められる. せん妄は健康人では認められることはほとんどなく, 入院患者の約15~30%に認められる. |
Author | 岸, 泰宏 |
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Title | 精神疾患と身体疾患の合併―臨床的·医療経済的インパクトならびにその治療システム |
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