Psychiatric patients and treatments in 1997: findings from the American Psychiatric Practice Research Network.
ABSTRACT Despite extensive studies on the epidemiology of mental disorders and advances in the treatment of these conditions, there is a paucity of detailed information concerning the characteristics of psychiatric patients and how treatments are administered in routine psychiatric practice. This 1997 observational study collected detailed information from 417 psychiatrists on the demographic, diagnostic, clinical, and treatment characteristics of a systematic sample of 1228 patients. Six hundred thirty-seven patients (51.9%) were women and the mean patient age was 41.9 years. The most common diagnostic category (53.7%) was mood disorders, followed by schizophrenia/psychotic disorders (14.6%), anxiety disorders (9.3%), and disorders of childhood (7.7%). Six hundred seventy-one patients (54.6%) had at least one comorbid Axis I condition and almost half (49.8%) had a history of psychiatric hospitalization. Patients received a mean of 2.0 psychotherapeutic medications, most commonly antidepressants (62.3%). Findings demonstrate that psychiatrists in routine practice treat a patient population with severe, complex conditions.
- [Show abstract] [Hide abstract]
ABSTRACT: ONE HUNDRED AND FIVE PATIENTS WITH PRIMARY UNIPOLAR DEPRESSION WERE RANDOMLY DIVIDED INTO THREE GROUPS: drug group (Seroxat administration), acupuncture group (Seroxat plus acupuncture), and electroacupuncture group (Seroxat plus acupuncture plus electroacupuncture). Patients' symptoms were evaluated using a psychometric questionnaire, the Symptom Checklist-90, before intervention and after 2, 4, 6 and 10 weeks of treatment. The individual factor scores and the total score from the Symptom Checklist-90 reduced in all three groups as treatment progressed. In the acupuncture and electroacupuncture groups, the total score and the factor scores for obsessive-compulsive symptoms, depression, and anxiety were significantly lower than those in the drug group. There was no significant difference in the factor scores or total scores between the acupuncture and electroacupuncture groups. Some factor scores in the electroacupuncture group, such as somatization, depression, hostility, and phobic anxiety, were increased at 10 weeks compared with the respective score immediately after the course of electroacupuncture at 6 weeks. Our findings indicate that administration of Seroxat alone or in combination with acupuncture/electroacupuncture can produce a significant effect in patients with primary unipolar depression. Furthermore, acupuncture/electroacupuncture has a rapid onset of therapeutic effect and produces a noticeable improvement in obsessive-compulsive, depressive and anxiety symptoms.Neural Regeneration Research 01/2014; 9(2):213-22. · 0.23 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Our objective was to assess whether specific health plan, patient, setting, and psychiatrist characteristics are associated with conformance with key evidence-based practice guideline psychopharmacologic treatment recommendations for major depressive disorder (MDD). Nationally generalizable data from the APA Practice Research Network 1997 Study of Psychiatric Patients and Treatments on 406 adult patients of psychiatrists with MDD were used. This observational study used logistic regression to assess factors associated with guideline conformance. Existing data from a psychiatric practice research network were analyzed. Ninety-one and seven-tenths percent of patients received treatment consistent with the recommendations. Conformance with specific recommendations was as follows: (1) an antidepressant or ECT for moderate, severe, or recurrent depression (92.3%); (2) an antidepressant and an antipsychotic or ECT for psychotic depression (80.9%); (3) an antidepressant and/or psychotherapy for mild depression (97.6%); and (4) no antianxiety medications alone without an antidepressant (96.0%). Variables most strongly associated with nonconformance were (1) lack of psychiatrist financial incentives (OR = 9.6; 95% CI = 1.2, 75.4), (2) psychiatrists with low proportions of public patients (OR = 7.8; 95% CI = 1.9, 32.1), (3) nonmanaged plans (OR = 3.8; 95% CI = 1.4, 10.4), and (4) psychiatrists 62 years or older (OR = 2.9; 95% CI = 1.2, 7.3). Although overall conformance was high, findings have implications for targeting quality improvement initiatives. Research is needed to distinguish clinically appropriate from inappropriate reasons for nonconformance and assess conformance with other recommendations.Mental Health Services Research 01/2000; 2(4).