ABSTRACT
Objective The study is designed to evaluate the difference in identification for depression and clinical effectiveness of its treatment between psychiatrists and non-psychiatric Dhysieians at out-patient departments of general hospitals and to analyze its related factors.Methods Totally,680 patients who visited psychiatric clinics in nine general hospitals of Shanghai at first time were screened by psychiatrists using Composite International Diagnostic Interview(CIDI)for depression and the screening resuhs were compared to the diagnosis made by non-psychiatric physicians as goal-keepers there.Altogether 297 patients with depression were recruited and assessed using Hamilton Depression Rating Scale(HAMD)and Hamilton Anxiety Rating Scale(HAMA).A self-made questionnaire for basic information was used to assess the ability for identification of depression in non-psychiatric physicians of general hospitals.Results Psychiatrists identified depression correctly in 337 of 680 patients who visited psychiatric clinics in general hospitals at their first visit,but non-psychiatric physicians only identified 216 patients,with statistically significant difference(χ2=30.73,P=0.000).A consistent agreement on depression diagnosis between the findings by psychiatrists and by CIDI was reached with Kappa of 0.774,but Kappa for that between the findings by non-psychiatric physicians and CIDI was 0.439.Effectiveness of treatment for depression by psychiatrists was better than that by non-psychiatric physicians,with higher total score and scores for each item of HAMD four,eight and 12 weeks after treatment,respectively(P＜0.05 or P＜0.01).Length of professional work of non-psychiatric physicians and annual time for professional training in management of mental disorders associated with their ability of identification for depression(P＜0.05).Conclusion Ability of non-psychiatric physicians to identify alQd cope with depression in the psychiatric department of general hospitals was insufficient,suggesting that more importance should be attached to the management of service quality at psychiatric department of general hospitals.
ABSTRACT
Objective To investigate the characteristics of the road traffic accident (RTA) casualties in Shanghai in 2003.Methods.The characteristics of RTA casualties were analyzed retrospectively on the data of Public Security Bureau and other related information.Results There were 54 197 RTA cases in 2003 with 1 406 death and 11 178 injured.The incidence rate and fatality of RTA was 311.48/10~4 and 11.17% respectively.The vehicle or population injury rate and mortality were 64.24/10~4,8.08/10~4,83.31/10~5 and 10.48/10~5,respectively.The fatality of suburb was higher than that of urban.Most of the casualties were bicyclist,pedestrians and motorcyclist,ranged mainly from 21 to 50 years old. Head injury and multiple traumas were the leading cause of death.Conclusion The RTA related injury had become a public health problem.The key strategies to decrease the fatality and disability of RTA were to propagandize the traffic safety perception in citizen and enforce the construction of rescue system for RTA including the EMSS.