“身病”之外还有心病 ？ "Body disease"There are heart ?

慢性病人普遍伴有不同程度心理问题 Chronic patients with different degree of common psychological problems

　　日前，广东省非精神科医生精神心理诊疗培训计划正式启动，一组数据显示出此次培训计划的重要性和迫切性。调查发现，前来医院求治的病人尤其是久病不愈的慢性病人中有三至五成会出现不同程度的心理问题，但统计数据表明，到精神心理科做心理咨询的病人仅一千例。其中的一个重要原因，即非精神科医生没有想到病人可能“身病”之外还有“心病”。

a,Guangdong province not psychiatrists mental medical training plan official start,A set of data shows that the training plan of the importance and urgency.Survey found,To come to the hospital QiuZhi patients especially not more chronic long illness of three to fifty percent will appear different degree of psychological problems,But statistics show,To do mental division of psychological counseling only one thousand cases patients.One of the important reasons,That is, psychiatrists didn't think the patient may"Body disease"There are"heart".

　　广东省卫生厅副厅长耿庆山表示，一方面，躯体疾病患者可伴发精神障碍；另一方面，由于患者自己不一定能确定应该看什么医生，加上精神疾病的“标签”作用，以及精神疾病本身表现的不典型性，而使大量的精神障碍病人涌入医院的非精神科。由此导致的后果是，那些久患身体疾病而同时伴有抑郁焦虑的病人，未能得到及时识别和有效治疗。

Guangdong provincial health bureau deputy director GengQingShan said,On the one hand,The body disease patients comorbid mental disorders can be;On the other hand,Because the patient's own can not determine what should see the doctor,With the spirit of the disease"label"role,And mental illness itself performance is not representativeness,And make a large number of patients with mental disorders in the hospital the psychiatric.Thus lead to consequences are,For those who suffer from physical diseases at the same time accompanied by anxiety of patients,Failed to get timely recognition and effective treatment.

躯体疾病普遍伴有心理问题 The body disease with common psychological problems

　　一项关于广州地区综合性医院门诊病人的调查结果表明，抑郁和焦虑是病人去看非精神病科门诊的主要原因。统计数据表明，去年广东省人民医院全年有372万多人前来就诊，其中内科住院病人181万多人，但到精神心理科做心理咨询的病人仅一千例。这种现象在各大综合医院十分普遍。

A about guangzhou general hospital outpatient survey results show that,Depression and anxiety is the patient went to see the psychiatric outpatient service of the main reason.Statistical data show that,Guangdong province people's hospital last year more than 3.72 million people throughout the year to come round to see a doctor,The in-patients in more than 1.81 million people,But to do mental division of psychological counseling only one thousand cases patients.This kind of phenomenon in each big general hospital is very common.

　　据专家介绍，在现代社会，传染病、寄生虫病、营养缺乏病已经不再是威胁生命的主要疾病，它们在“疾病谱”和“死因谱”中所占的地位已不重要。相形之下，与心理性、社会性因素有关的疾病却显著增高，以排名前三位的死因恶性肿瘤、心血管疾病和脑血管疾病为例，都包含有心理紧张、吸烟、环境污染等心理、社会因素在内。

According to expert introduction,In the modern society,Infectious diseases/Parasitic disease/Deficiency disease is no longer the main life threatening diseases,They are"disease"and"Death spectrum"For status has not important.In contrast,And heart rational/Social factors related disease is increased significantly,With the top three death malignant tumor/Cardiovascular disease and cerebrovascular disease, for example,Contains mental tension/smoking/Environment pollution and so on psychological/Social factors,.

　　至于公害病、交通事故、自杀、吸毒、酗酒、饮食过度以及其他种种心理社会原因而引起的心因性疾病的广泛发生，更主要是来自心理和社会因素。而对于走在改革开放发展前沿、社会竞争激烈的广东省而言，以上形势显得尤为严峻。

As for the public nuisance disease/Traffic accident/suicide/drugs/drinking/Pampering, and a variety of other psychological social reasons and cause psychogenic diseases occur widely,More is mainly from the psychological and social factors.And to walk in the forefront of reform and opening up development/The fierce competition in Chinese society in guangdong province,Above the situation is particularly serious.

　　“患病越重的人出现心理问题的可能性越大，比如癌症、恶性肿瘤等，此外患有一些慢性病的人也比较容易出现焦虑、抑郁等症状。”广东省人民医院院长庄建对记者表示，有一些病人即使得了抑郁症，也不愿意承认，一直不愿意去看精神科，导致影响了治疗效果。

"The heavier sick people appear the likelihood of psychological problems,Such as cancer/Malignant tumor,In addition with some chronic disease also is easier to appear anxiety/Depression symptoms such as."The guangdong province people's hospital director, told reporters,There are some patients even depressed,Also don't like to admit,Didn't want to go to see the psychiatric,Lead to influence the treatment effect.

　　据WHO组织的一项多国研究表明，在综合医院门诊与住院患者中，大约有25%-30%伴有不同程度的心理障碍。也有的是由于心理疾病引起的躯体症状为表现，但患者或家属自认为是躯体疾病，就到其他临床科室看医生。

According to WHO organization a multinational study,In the general hospital outpatient service and hospital patients,About 25% - 30% with different degree of psychological disorder.Also have a plenty of because of psychological diseases caused by the body symptoms for performance,But the patient or family member that is from the body disease,Went to other clinical departments see a doctor.

　　据介绍，有一位患者自诉腹胀腹痛、恶心呕吐，总认为自己有严重胃病，但经多次检查，没有发现消化系统器质性病变，服药也没有效果。转入精神心理病房后，经检查确诊为焦虑症，而后针对引起焦虑的原因进行心理疏导，并服用抗焦虑药物，仅半个月焦虑症状就明显减轻，腹痛、恶心等感觉也随之消失。

According to introducing,There is a private prosecution abdominal distension in patients with abdominal pain/Nausea and vomiting,Always think he has the serious stomach trouble,But after repeated examination,Found no organic disease digestive system,Take medicine also have no effect.Into the spirit after psychological ward,Through inspection diagnosed with anxiety,And then according to the anxiety caused by the reason of psychological counseling,And taking anxiolytic drugs,Only half a month anxiety symptoms significantly reduce,Abdominal pain/Nausea feeling ceases.

“头痛医头，脚痛医脚”现象普遍 "Instant gratification,JiaoTongYiJiao"Phenomenon common

　　精神卫生问题在中国普遍存在。一项基于在中国的4个大型城市的调查结果表明，大约有1.73亿中国人患有精神疾病，其中1.58亿人从来没有得到任何类型专业人士的帮助。在21世纪，精神、心理和行为问题被认为是中国人群健康状况不佳和生产力下降的主要原因，至少占疾病总负担的五分之一。

Mental health problem in China universal existence.A based on China's four big cities survey results show that,About 173 million Chinese people suffering from mental illness,158 million of them have never get any type professional help.In the 21st century,spirit/Psychological and behavioral problems is considered to be the Chinese poor health and productivity of the main reason for decline,At least one 5 of the total burden of disease.

　　在2007年，中国国家精神卫生中心估计，50%的门诊患者(非精神科)为抑郁症患者。随着经济的迅速发展，我国精神疾病的患病率还在迅速上升。然而，与此相对应的是，在中国将近14亿的人口中，仅有不到2万名注册的精神科医生，即每百万人口或每10000名精神病患者只有不到15名精神科医生为他们提供服务。

In 2007,China's national center for mental health estimation,50% of clinic patients(Non psychiatric)For patients with depression.Along with the rapid economic development,Our country the prevalence of mental illness is rising rapidly.however,The flipside is,In China, nearly 1.4 billion population,Less than 20000 registered psychiatrist,That is every populations or every 10000 psychiatric patients less than 15 psychiatrist to offer them service.

　　“实行精神卫生工作任务的转移，即由非精神病专科医院来承担一部分治疗精神病任务的试验，将会成为全球精神卫生提高的典型。”耿庆山表示，随着“生物－心理－社会”医学模式的转变，人们对心理问题逐步重视起来了。这一新医学模式认为除了生物学观点外，还必须考虑人的心理和人与环境的关系。

"Implement the spiritual health of the work shift,That is a psychiatric hospitals to take part of the task of psychotropic test,Will become the world mental health improvement of typical."GengQingShan said,with"Biological - psychology - social"The transformation of medical model,People to pay more attention to psychological problems gradually up.The new medical model that in addition to the biological point of view,Must also consider the person's psychology and the relationship between human beings and the environment.

　　然而，在中国实现这一医学模式的转变并非易事。有许多医生在理论上缺乏训练，在实践中也没有身体力行。例如，目前临床各科的不少医生不懂得躯体疾病合并精神心理疾病的诊治，甚至不能识别一些简单的心身疾病，从而达不到既治愈躯体疾病，更医好精神、心理的目的。

however,In China to achieve this the transformation of medical model is not easy.There are many doctors lack of training in theory,In practice is not physically.For example,The clinical doctors don't know a lot of all the body disease merger spirit psychological diseases, clinical diagnosis and treatment,Can't even identify some simple psychosomatic disease,Thus reach the body disease is cured,More healed spirit/Psychological purpose.

　　“大部分医生‘头痛医头，脚痛医脚’，只注重解决躯体疾病，患者受到的服务支离破碎，很多医患纠纷、医患关系冲突由此产生。”耿庆山指出，很多医生往往只关注近代、现代生物医学，重视科学技术，轻视人的社会性、心理性，“工匠化”和非人性化越来越加剧，以至医疗保健过程成为环节越来越多的工业流水线式操作过程，操作者对终极结果的关心越来越淡薄。

"Most of the doctors‘Instant gratification,JiaoTongYiJiao’,Only pay attention to solve the body disease,Patients are service fragmented,A lot of doctor-patient dispute/The doctor-patient relationship conflict arising therefrom."GengQingShan pointed out that,Many doctors tend to focus on modern/Modern biomedical,Pay attention to science and technology,Despise people's social/Heart rational,"Craftsmen turn"And the human nature more and more intensifying,That health care process becomes link more and more industrial pipeline type operation process,The operator to the ultimate results concern more and more light.

非精神科医生培训启动 The psychiatrist training start

　　“单靠精神科医生‘坐堂式’的会诊毕竟不是理想的解决问题的方法，还需要更多的非精神科医生具有一定的识别和处理精神心理问题的能力。”耿庆山表示，医院非精神科医生对精神科问题的识别和处理能力仍令人担忧，因此，针对非精神科医生开展各种形式的精神卫生继续医学教育是当务之急。

"Single by psychiatrists‘Gabbatha type’Consultation, after all, is not the ideal methods to solve the problems,Still need more than psychiatrist has certain recognition and treatment mental problem ability."GengQingShan said,The hospital not psychiatrists for psychiatric problem identification and handling ability are still worrying,therefore,According to the psychiatrist carry out various forms of continuing medical education for mental health is a priority.

　　广东省非精神科医生精神心理诊疗技能培训项目应时而生。据介绍，该项目初步的培训计划包括：2012年度－2013年1月计划培训15家医院的医生，培训人群是三级甲等医院非精神科住院医生、主治及进修医师、在读的硕士和博士研究生。

Guangdong province not psychiatrists spirit psychological diagnosis and treatment skills training programs should sometimes born.According to introducing,The project preliminary training plan including:2012 annual 2013 - January plan training 15 hospital doctor,Training the crowd is three level of first-class hospital non psychiatric hospital doctors/The attending physician and further/Reading master and doctoral students.

　　据介绍，之所以先培训三甲医院的医生，是因为三级甲等医院就诊量大、病种复杂，其非精神科住院医师是临床一线医生，与患者直接接触，必须对患者合并的精神心理疾病有系统的认识，才能更好地识别其精神心理疾病，从而反馈给上级医生，以便在上级医生指导下制定更好的诊治计划和院外保健、康复计划。

According to introducing,The first training 3 armour hospital doctor,Because three level of first-class hospital JiuZhenLiang big/Disease complex,Its not psychiatric resident is clinical doctors,And direct contact with the patients,The spirit of the merger to patients with mental illness have understanding of the system,To better identify their spiritual mental illness,Thus feedback to superior doctors,In order to make higher under the guidance of doctors better make a diagnosis and give treatment plan and lobbyists health care/Rehabilitation program.

　　“主要是想让他们学会识别、诊治常见精神心理疾病，以及容易发生于患有躯体疾病患者身上的精神心理疾病的鉴别。”据耿庆山介绍，很多非精神科医生在遇到带有精神症状的病人时，或者无法识别病人的精神症状，或者处理这些问题时不规范、不系统。而国外有研究表明，对非精神科医师进行教育培训及实践指导，不仅能改进他们对患有躯体疾病合并精神心理疾病患者的识别能力和治疗疗效，而且最终能减少这些疾病造成的人类疾病负担。(记者 赵兵辉)

"The main purpose was to let them learn to recognize/Make a diagnosis and give treatment common mental disease,And easy to occur in patients with somatic disease psychological disease the spirit of identification."According to GengQingShan introduced,Many non psychiatrists in the encounter with a mental patient symptoms,Or can't identify patients' mental symptoms,Or deal with these problems is not standard/Don't system.And foreign studies show,To a psychiatrist for education training and practice guidance,Can not only improve their body disease to suffer from mental disease merger recognition ability and curative effect,And finally can reduce the disease cause of human disease burden.(Reporter ZhaoBing fai)