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Abstract

第125巻第2号

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Psychoanalytical Psychiatry in the Field of Liaison Psychiatry
Hiroyuki KIMURA
Department of Psychiatry, Nagoya University Graduate School of Medicine
Psychiatria et Neurologia Japonica 125: 135-144, 2023
https://doi.org/10.57369/pnj.23-018

 The roots of consultation-liaison psychiatry (or liaison psychiatry) can be traced to 1902, when Albany General Hospital in New York was struggling to deal with psychiatric symptoms in patients treated for physical conditions, and therefore added a psychiatry unit. Psychoanalysis emerged around the same time. In 1981, shortly after liaison psychiatry's introduction to Japan in 1977, the Japanese Psychoanalytic Association held a symposium titled "Psychoanalysis and Liaison Psychiatry" to discuss the influence of the patient's unconscious on medical personnel and group dynamics in team medicine. However, with the loss of the psychoanalytic perspective in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) released around the same time, opportunities to study psychoanalysis as part of medical school education diminished. As a result, the connection between liaison psychiatry and psychoanalysis largely disappeared.
 In actual clinical situations, however, psychoanalysis has often contributed to the consultation-liaison field. This has occurred in various ways, such as sharing a dynamic understanding of the clinical situation of patients with physical illnesses on the basis of group dynamics with a medical team, or by providing individual psychotherapy to patients suffering from such illnesses. Physical medicine has also placed less emphasis on psychiatric liaison activities since the 1990s, when a direct relationship was clearly shown between psychiatric symptoms of patients with multiple physical diseases and the prognosis of their physical disease. Furthermore, in Japan, team medicine has been widely promoted since 2000. In recent years, evidence has been disseminated regarding the therapeutic effects of liaison psychiatry in team medicine. In daily clinical practice, there are strong expectations that psychiatrists will be part of the medical team. It is necessary for psychiatrists to acquire additional psychiatry-based skills to become able to effectively work in such a team.
 This paper provides a historical overview of Psychoanalytical Psychiatry in the field of liaison psychiatry, and discusses their contemporary significance.
 Author's abstract

Keywords:psychoanalytical psychiatry, consultation liaison, liaison psychiatry, team medicine>
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