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.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
The percentage of patients (N=1124) receiving psychiatric care in various treatment settings. HMO indicates health maintenance organization.
Current treatment services provided by the psychiatrist (N=1228 patients). Psychiatrists were asked to check all that applied. Patients who received more than 1 service during the current visit were counted in each of the relevant service categories, so percentages add to more than 100%. Medication represents patients who were receiving 1 or more medications at the time of the visit, regardless of whether this medication was monitored or adjusted. Psychiatric management was defined as monitoring clinical status; educating patients and families; prescribing, monitoring, or adjusting medications and/or other treatments; establishing and maintaining a therapeutic alliance; and developing or modifying treatment plans. Psychotherapy includes individual, group, and couples/family therapy.
Percentage of patients (N=1228) receiving medications, by medication class. Patients receiving more than 1 type of medication were counted in each of the relevant categories, so percentages add to more than 100%. Categories are parallel to those in the Physicians' Desk Reference25 and refer to medication type (eg, antidepressant) rather than treatment indication (eg, for the treatment of an anxiety disorder). General medical indicates medications that are not psychotropic but may be prescribed for the treatment of psychiatric symptoms or psychotropic side effects (eg, antihypertensive and antiparkinsonian medications); anti–substance use includes antibuse, naltrexone, and methadone hydrochloride; and other includes vitamins and herbal remedies prescribed by the psychiatrist. In cases in which a substance had more than 1 therapeutic classification (eg, clonazepam), it was listed in the category for which it was thought to be most commonly prescribed.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Psychiatry editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 73
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.