An English-speaking psychiatrist at a public outpatient mental health clinic meets with a Chinese-speaking patient referred by a GP.
- Psychiatrist · turn 1
Good morning, Mr Wang. I'm Dr Taylor, the psychiatrist your GP referred you to. Please have a seat. Before we begin, I'd like to let you know that everything we discuss today will remain confidential unless I'm concerned that you or someone else is at immediate risk of harm. Is that alright?
早安，王先生。我是Taylor醫生，也是您的家庭醫生轉介您前來就診的精神科醫生。請坐。在開始之前，我想讓您知道，我們今天討論的一切都會保密，除非我擔心您或其他人正面臨即時傷害的風險。您同意嗎？
- Patient · turn 2
好的，醫生。我明白。我是第一次來看精神科，所以有點緊張。
All right, doctor. I understand. This is my first psychiatric appointment, so I’m a little nervous.
- Psychiatrist · turn 3
That's completely understandable. Could you tell me what has been troubling you recently?
這完全可以理解。您可以告訴我最近有甚麼事情困擾着您嗎？
- Patient · turn 4
我這半年來一直睡不好，幾乎每天晚上都要躺兩、三個小時才能睡著，而且半夜常常醒來。
I haven’t been sleeping well for the past six months. Almost every night, I have to lie in bed for two or three hours before falling asleep, and I frequently wake during the night.
- Psychiatrist · turn 5
Besides your sleep problems, have you noticed any changes in your mood?
除了睡眠問題之外，您有注意到情緒出現任何變化嗎？
- Patient · turn 6
有。我每天都覺得心情很低落，對以前喜歡做的事情完全提不起興趣，也不太想出門見人。
Yes. I feel very low every day, have completely lost interest in activities I previously enjoyed and don’t really want to go out or see anyone.
- Psychiatrist · turn 7
Have you experienced excessive worry or anxiety?
您有過度擔憂或焦慮嗎？
- Patient · turn 8
幾乎每天都會。我總是擔心工作、擔心家人，甚至一些很小的事情也會一直想個不停，根本停不下來。
Almost every day. I constantly worry about work and my family. I even think repeatedly about very minor matters and simply can’t stop.
- Psychiatrist · turn 9
Have you ever experienced a panic attack? For example, sudden chest tightness, difficulty breathing, dizziness or the feeling that something terrible was about to happen?
您曾經恐慌發作嗎？例如突然胸悶、呼吸困難、頭暈，或感覺即將發生可怕的事情？
- Patient · turn 10
有，大概三個星期前。我突然喘不過氣，心跳得很快，手一直發抖，我還以為自己快要心臟病發了，所以叫救護車去了急診。
Yes, about three weeks ago. I suddenly couldn’t breathe, my heart was beating very quickly and my hands kept shaking. I thought I was about to have a heart attack, so I called an ambulance and went to the emergency department.
- Psychiatrist · turn 11
I can see why that frightened you. The emergency department notes suggest it was most likely a panic attack rather than a heart problem.
我明白這為甚麼會令您害怕。急症室的紀錄顯示，那很可能是恐慌發作，而不是心臟問題。
- Patient · turn 12
他們也是這麼跟我說，可是我還是很害怕，現在只要一想到那天的情況，我就開始緊張。
That is what they told me as well, but I’m still very frightened. Now, whenever I think about what happened that day, I begin to feel anxious.
- Psychiatrist · turn 13
Have you ever harmed yourself or had thoughts of ending your life?
您曾經傷害自己，或有過結束生命的想法嗎？
- Patient · turn 14
我沒有傷害過自己，也沒有真的想自殺。不過有時候我會覺得活著很累，希望睡著以後就不用再面對這些事情了。
I’ve never harmed myself and haven’t genuinely wanted to take my own life. However, sometimes I feel that living is exhausting and wish that, after falling asleep, I wouldn’t have to face these things again.
- Psychiatrist · turn 15
Thank you for being honest with me. It's important that I understand exactly how you're feeling. If those thoughts become stronger or you feel you might act on them, please seek help immediately.
謝謝您坦誠告訴我。讓我準確了解您的感受非常重要。如果這些想法變得更加強烈，或您覺得自己可能會付諸行動，請立即尋求協助。
- Patient · turn 16
好，我會的。我其實很想好起來，只是不知道該怎麼辦。
All right, I will. I genuinely want to get better; I simply don’t know what to do.
- Psychiatrist · turn 17
Have you received any treatment for your mental health before, such as counselling, psychological therapy or medication?
您以前有接受過任何心理健康治療嗎？例如輔導、心理治療或藥物治療。
- Patient · turn 18
沒有。我家庭醫生之前建議我去看心理學家，不過我一直覺得自己可以撐過去，所以沒有去。
No. My GP previously suggested that I see a psychologist, but I always felt that I could get through it by myself, so I didn’t go.
- Psychiatrist · turn 19
I understand. Sometimes people hope things will improve on their own, but seeking help early often leads to better outcomes.
我明白。有時候，人們希望情況會自行改善，但及早尋求協助通常會帶來更好的結果。
- Patient · turn 20
我現在有點後悔。如果早一點接受治療，也許就不會變得這麼嚴重。
I regret that somewhat now. If I had received treatment earlier, perhaps it wouldn’t have become so serious.
- Psychiatrist · turn 21
I'd like to arrange a blood test to rule out any underlying physical conditions, such as thyroid problems. At the same time, I think you may be experiencing moderate depression with significant anxiety symptoms.
我想安排血液檢查，以排除甲狀腺問題等任何潛在身體疾病。同時，我認為您可能正患有中度抑鬱症，並伴有明顯焦慮症狀。
- Patient · turn 22
所以我的情況不是單純壓力太大嗎？
So my condition isn’t simply caused by excessive stress?
- Psychiatrist · turn 23
Stress may have contributed to it, but I believe there's more going on. I'd recommend a combination of medication and psychological therapy.
壓力可能是其中一個因素，但我相信還有其他問題。我建議結合藥物和心理治療。
- Patient · turn 24
一定要吃藥嗎？我有點擔心會不會上癮，或者吃了以後整天昏昏沉沉。
Do I definitely need to take medication? I’m somewhat worried that I might become addicted or feel drowsy all day after taking it.
- Psychiatrist · turn 25
That's a common concern. The antidepressant I'm recommending isn't addictive. Like any medication, it can cause side effects, but most people tolerate it well and the side effects usually improve after the first few weeks.
這是常見的擔憂。我所建議的抗抑鬱藥不會令人上癮。和任何藥物一樣，它可能引起副作用，但大多數人都能良好適應，而副作用通常會在最初幾星期後有所改善。
- Patient · turn 26
那我需要吃多久？
How long will I need to take it?
- Psychiatrist · turn 27
Generally, we recommend continuing the medication for at least six to twelve months after your symptoms improve. We'll monitor your progress closely and adjust the treatment if necessary.
一般而言，我們建議在症狀改善後繼續服藥至少六至十二個月。我們會密切監察您的進展，並在有需要時調整治療。
- Patient · turn 28
明白。我對青黴素過敏，這會有影響嗎？
I understand. I’m allergic to penicillin. Will that have any effect?
- Psychiatrist · turn 29
Thank you for letting me know. That allergy won't affect the medication I'm planning to prescribe, but I'll record it in your medical history.
謝謝您告訴我。這項過敏不會影響我計劃處方的藥物，但我會在您的病歷中記錄。
- Patient · turn 30
好的。
All right.
- Psychiatrist · turn 31
I'd also like to refer you to a clinical psychologist for cognitive behavioural therapy. Research shows that combining medication with therapy often produces the best results.
我也想轉介您去看臨床心理學家，接受認知行為治療。研究顯示，藥物與心理治療相結合，往往能帶來最佳效果。
- Patient · turn 32
精神科醫生、心理學家和輔導員有什麼不同？
What is the difference between a psychiatrist, a psychologist and a counsellor?
- Psychiatrist · turn 33
As a psychiatrist, I'm a medical doctor and can diagnose mental illnesses and prescribe medication. A psychologist provides psychological assessment and therapy, while a counsellor mainly offers emotional support and counselling for personal or life difficulties.
作為精神科醫生，我是一名醫生，可以診斷精神疾病和處方藥物。心理學家提供心理評估和治療，而輔導員主要就個人或生活困難提供情緒支援和輔導。
- Patient · turn 34
原來如此，我一直以為他們都是一樣的。
I see. I always thought they were all the same.
- Psychiatrist · turn 35
Before you leave today, we'll organise your blood test, send the referral to the psychologist, and book a follow-up appointment in four weeks. If your symptoms suddenly become worse or you have thoughts of harming yourself, please go to the nearest emergency department or call Triple Zero immediately.
在您今天離開之前，我們會安排血液檢查、把轉介信送給心理學家，並預約四星期後覆診。如果您的症狀突然惡化，或出現傷害自己的想法，請立即前往最近的急症室或致電000。
- Patient · turn 36
好的，謝謝醫生。我終於知道自己該怎麼做了，希望可以慢慢好起來。
All right. Thank you, doctor. I finally know what I should do and hope that I can gradually recover.
- Psychiatrist · turn 37
You're taking an important first step today. We'll work together on your recovery.
您今天踏出了重要的第一步。我們會共同努力，協助您康復。
- Patient · turn 38
謝謝您，醫生。
Thank you, doctor.
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