Prescribing of Psychotropic Medication by Primary Care Physicians and Psychiatrists

Beardsley, Robert S.; Gardocki, Gloria J.; Larson, David B.; Hidalgo, Julia

doi:10.1001/archpsyc.1988.01800360065009

Cited by 112 publications

(51 citation statements)

References 13 publications

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“…General medical physicians also facilitate or impede access to mental health specialty services through referral decisions (3,4). A survey of U.S. adults with depressive and anxiety disorders found that only 1.9% visited a mental health specialist without seeing a primary care physician (5).…”

Section: Introductionmentioning

confidence: 99%

Psychiatric Treatment in Primary Care Patients With Anxiety Disorders: A Comparison of Care Received From Primary Care Providers and Psychiatrists

Weisberg¹,

Dyck²,

Culpepper³

et al. 2007

AJP

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Objective-To examine the psychiatric treatment received by primary care patients with anxiety disorders and compare treatment from primary care physicians and psychiatrists.Method-Primary care patients at 15 U.S. sites were screened for anxiety symptoms at the time of a medical visit. Those screening positive were interviewed to assess for anxiety disorders. Information on psychiatric treatment received and provider of pharmacological treatment was collected.Results-Of 539 primary care participants with at least one anxiety disorder, almost half (47.3%) were untreated. Nearly 21% were receiving only medication for psychiatric problems, 7.2% received psychotherapy alone, and 24.5% received both medication and psychotherapy. Patients getting psychopharmacologic treatment received similar medications, often at similar dosages, regardless of whether their prescriber was a primary care physician or a psychiatrist. One exception was that patients were less likely to be taking benzodiazepines if their provider was a primary care physician. Those receiving medications from a primary care provider were also less likely to be in psychotherapy. Overall, patients with more functional impairment, more severe symptoms, and comorbid major depression were more likely to receive mental health treatment. Members of racial/ethnic minority groups were less likely to be treated. Frequently endorsed reasons by patients for not receiving pharmacological treatment were that the primary care physician did not recommend it and not believing in taking medication for emotional problems.Conclusions-Nearly half of primary care patients with anxiety disorders were not treated. However, when treated, care received from primary care physicians and psychiatrists was relatively similar.

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Section: Introductionmentioning

confidence: 99%

Psychiatric Treatment in Primary Care Patients With Anxiety Disorders: A Comparison of Care Received From Primary Care Providers and Psychiatrists

Weisberg¹,

Dyck²,

Culpepper³

et al. 2007

AJP

View full text Add to dashboard Cite

show abstract

“…However, Craig, et al, also found that surveyed women taking minor tranquilizers and sedatives included significantly more respondents with high depression scores, and that depressed respondents of both sexes tended to be taking anxiolytics or sedatives, and not antidepressants. 28 Beardsley, et at 29 found that primary care practitioners provided 72 percent of all anxiolytic drug visits, but documented a psychiatric diagnosis in a minority of anxiolytic drug visits, raising questions about the specificity of anxiolytic use in primary care settings. Although anxious and depressive symptoms are often admixed, the present findings of high anxiolytic use among depressed respondents suggest that depressive symptoms are underrecognized.…”

Section: Introductionmentioning

confidence: 99%

Benzodiazepine anti-anxiety agents: prevalence and correlates of use in a southern community.

Swartz

Landerman²,

George³

et al. 1991

Am J Public Health

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BACKGROUND: Benzodiazepine anti-anxiety agents are the most widely prescribed psychotherapeutic drugs in the United States today. Recent evidence, however, suggests that their use may be decreasing. METHODS: We examine the population prevalence and correlates of use of benzodiazepine anxiolytics at the Duke site of the NIMH-sponsored Epidemiologic Catchment Area project. RESULTS: Bivariate analysis of use patterns for the drugs revealed demographic predictors similar to those reported in previous studies: increased likelihood of use by the elderly, Whites, women, the less educated, and the separated or divorced. Use is also associated with symptoms of psychic distress, negative life events, use of health care services, and diagnoses of affective disorder, agoraphobia with panic, and panic disorder. Age, sex, race, education, and marital status remain associated with non-hypnotic benzodiazepine use in a logistic regression analysis. CONCLUSIONS: Multivariate analyses of these data indicate that when potential confounding factors are controlled, age, sex, race, education, and marital status are significantly related to benzodiazepine anxiolytic use but the effects of sex and education are mediated by intervening variables. Implications of these findings are discussed particularly in relation to high levels of use in the elderly.

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“…A growing trend in both civilian and military sectors is integration of mental health professionals into primary care medical practices. Integration has several potential benefits, including increased recognition of mental disorders, improved clinical outcomes and satisfaction with care, and reduction in health care costs (Beardsley et al, 1998;Smit et al, 2006;Katon, Von Korff, et al, 1995;Katon, Robinson, et al, 1996). Mental health practitioners provide unique services in primary care settings, including "short, focused assessments; brief interventions in support of the primary care treatment plan; skill training through psycho-education and patient education strategies; training in self-management skills and behavioral change plans; and on-the-spot consultation" (Department of Defense Task Force on Mental Health, 2007a, p. 18).…”

Section: What Structural Factors Impede or Facilitate Access To Dod Mmentioning

confidence: 99%

Help a Buddy Take a Knee: Creating Persuasive Messages for Military Service Members to Encourage Others to Seek Mental Health Help

Clark-Hitt

Smith

Broderick

2012

Health Communication

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Prescribing of Psychotropic Medication by Primary Care Physicians and Psychiatrists

Cited by 112 publications

References 13 publications

Psychiatric Treatment in Primary Care Patients With Anxiety Disorders: A Comparison of Care Received From Primary Care Providers and Psychiatrists

Psychiatric Treatment in Primary Care Patients With Anxiety Disorders: A Comparison of Care Received From Primary Care Providers and Psychiatrists

Benzodiazepine anti-anxiety agents: prevalence and correlates of use in a southern community.

Help a Buddy Take a Knee: Creating Persuasive Messages for Military Service Members to Encourage Others to Seek Mental Health Help

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