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《精神科で学んだ研修医の声・その1》「自分が恥ずかしいです」 | お知らせ | 群馬大学大学院医学系研究科 神経精神医学教室

群馬大学大学院医学系研究科 神経精神医学教室Department of Psychiatry and Neuroscience, Gunma University Graduate School.

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研修医の方へ

《精神科で学んだ研修医の声・その1》
「自分が恥ずかしいです」

「若手医師に伝えたい精神科診療の基本-精神科の入院治療の基本」という文章を読んだ研修医の感想をご紹介します。精神科の研修で、大切なことを学んでもらえていることが、良く伝わってくる頼もしい感想です。

* * *

目から鱗が落ちるような思いがいたしました。

<生活が破綻しないことで病状が改善する> を読んで。

病状が悪化するからこそ生活が破綻する、のだとずっとそのように考えており、生活の破綻が病状を悪化させる、との視点では正直に申し上げて考えたこともありませんでした。

患者さんにお話いただく、ということは、破綻した生活がどのように病状悪化につながったか、それをどのように改善するのか、を知る必要性を含んでいることに改めて気付かされました。そうでないと、生活の破綻と病状の悪化という悪循環を続けてしまい、かつ、続けば続くほど両者ともにさらに悪化していくからだと考えます。

どうして精神科では、生活歴や家族構成などを詳細に聞くのかな、症状を中心に聞くべきではないのかな、と思っていた自分が恥ずかしいです。実際に症状から診断名をつけようと躍起になっていました。患者さんが話しにくい、お話をしていただけない理由はここにあったのだなあ、と。