关键词: 情感障碍, 精神病性；门诊病人；全科医生；医院, 专科；合作行为；文献荟萃；瓶颈；策略

Abstract: Background　Mental illness seriously endangers the health and life of residents.General practitioners（GPs）' collaborated with the psychiatric specialists is conductive to the diagnosis，treatment and management of mental disorders.But there are still many problems and obstacles in the current collaboration.More optimization strategies still need to be explored.Objective　 To analyze and explore the collaboration bottlenecks and strategies of GPs' diagnosis and treatment for outpatients with mental disorders，to provide theoretical basis for the application and optimization of strategies，so as to promote the diagnosis and treatment of mental diseases in communities.Methods　Searching the title of（“mental” OR “psycho” OR “psychiatry”）AND（“primary care” OR “general practice” OR “general practitioner” OR “family medicine”）in the databases of Web of Science，Pubmed，Elservier，China National Knowledge Infrastructure，WAN-FANGDATA and CQVIP，we retrieved literatures from January 1，2104 to December 31，2017.With the repeated literatures excluded，we analyzed the selected literatures involving the collaboration between general practice and psychiatric department.Results　 We retrieved 157 literatures.Eight of them involved the significance of collaboration，which mentioned its important values of clinical effects，cost saving，disease management，reducing stigma and discrimination，improving skills of GPs and saving general psychiatric resources.Three of them involved the deficiency of the collaboration status.Seventy-two of the literatures involved the collaboration strategies between general practice and psychiatric department，41 of which mentioned system plans，programs and models，31 of which mentioned other ways and channels of non-system strategies of collaboration; however，collaboration strategies were mostly in the construction stage，and their application effects in practice needed further study.Seventy-four of the literatures involved subjects being treated in general practice and psychiatric department，29 of which mentioned adolescents and children，and the rest of which mentioned other kinds of peoples.Sixteen of the literatures involved influencing factors of collaborations，including aspects of economy，manpower，drug prescription and technology，and obstacles in clinic，economy，duty and supervision.Seven of the literatures involved opinions of collaborations from GPs，psychiatrists，staff and patients.Eleven of the literatures involved the training of collaboration; they reported the cooperation between general practitioners and psychiatric specialists and the training of related knowledge and skills，but its long-term application and development in practice needed further study.Four of the literatures explored the collaboration between general practitioners and psychiatrists.Conclusion　GPs had collaboration obstacles and bottlenecks in the diagnosis and treatment of outpatients with mental disorders，including：the inadequacy of GPs' diagnosis and treatment，both GPs and psychiatrists lacking knowledge in collaboration，and many other obstacles influencing the collaboration.This also indicates the optimized strategies lies in program supports and resource optimizing.It is worth noting that the practice and persistence of the collaboration programs is needed.Resource optimization is reflected in rational investment and application of resources related to limited collaboration and policy support.

Key words: Affective disorders, psychotic；Outpatients；General practitioners；Hospitals, special；Cooperative behavior；Meta analysis；Bottlenecks；Strategies