Study On The Clinical Status Of The Patients With Mental Disorder In TCM Department And The Correlative Psychosocial Factors

Objective: To investigate the clinical status of the patients with mental disorder in TCM hospital(department). To analyse the clinical characters and the personality characters of the patients with various types of mental disorders and the relationship between mental disorders and TCM differentiation of syndromes. To study the correlativity between mental disorders and psychosocial factors.Method: To sampling 1318 patients (698 outpatients, 620 inpatients) in TCM department of the general hospital and the TCM hospital from August in 2003 to May in 2004, all join voluntarily and complete the test. 210 people are as normal control. All subjective completed the following questionnaires: general questionnaire, SCL-90, EPQ, LES, DSQ and SSRS by themselves. Diagnosing the sampled patients with CCMD-3 and recording their histories and the clinical status in the TCM department. Utilizing x~2 test, t test, correlativity analysis and stepwise regression analysis to analyse the collected data in SPSS 11.0 software.Results: (1) The incidence of mental disorders evaluated with SCL-90 in TCM hospital(department) is 39.83%. 18% of patients in TCM hospital (department) are diagnosed as mental disorder for CCMD-3. 43.98% of these mental disorders are neurosis and 26.39% of them are melancholia. 35.79% of these neuroses are anxiety neurosis and 26.32% of them are somatoform disorder. (2) The incidence of psychosomatic diseases in TCM hospital(department) is 33%. The incidence of somatopsychic disorders is 26.63%. (3) TCM differentiation of syndromes of mental disorders is mainly for the stagnation of liver-qi and the deficiency of spleen type and the deficiency of heart and spleen type. The symptoms of the patients with mental disorder evaluated with SCL-90 mostly are depression, anxiety, obsessive-compulsive symptoms and somatization, etc. Only 12.96% ofthem complained emotional symptoms to the TCM doctors. Their somatization symptoms mostly are insomnia, pain, asthenia, loss of appetite, hiccup, palpitation, dizziness, dyspnea, etc. The symptoms of gastrointestinal, cardiovascular and respiratory are most. (4) The patients with mental disorder seek treatment in TCM hospital(department) because they mostly believe TCM. They were made much more unnecessary examinations and costed higher. 49.07% of them were misdiagnosed. 76.85% of treatment aimed at their somatic symptoms. 70.06% of these patients didn't get better after they were treated. (5) Most patients with mental disorder possess personality characters of neuroticism, introversion and psychotic. They suffer more negative life events, use more immature defense styles and their social support is less.Conclusions: The mental health problems are commonly seen in TCM hospital(department). The incidence of mental disorders, psychosomatic diseases and somatopsychic disorders in TCM hospital (department) is higher. The patients with mental disorder weren't effective treated in time because the patients' more somatization and the TCM doctors' less psychiatry, which result in delaying to cure and wasting resources very much. The patients and their household know little about mental health and concern the somatic symptoms more rather than the mental symptoms. Mental disorder is correlative closely with psychosocial factors such as neuroticism personality, more negative life events, immature defense style and less social support. TCM contains special advantages in treating patients with mental disorder, but the TCM doctors should know more about psychiatry and combine with CLP and mental health service to utilize it better.