|Psychiatrists Shifting Away From Psychotherapy Role|
|SciMed - Neuroscience|
|TS-Si News Service|
|Monday, 11 August 2008 16:30|
Various forms of psychotherapy, either alone or in combination with medications, are recommended for the treatment of bipolar disorder, major depression, post-traumatic stress disorder, and other conditions dascribed as psychiatric illnesses.
National Trends in Psychotherapy by Office-Based Psychiatrists. Ramin Mojtabai and Mark Olfson. Archives of General Psychiatry 65(8) 962-970.
The psychiatric profession is the principal sponsor of the Manual for Diagnosis of Mental Disorders (DSM-V). The impact of a small profession that acts as the gatekeeper for the wider community of care givers has yet been subjected to objective measurement. It is also unknown whether the psychiatric profession can sustain itself with minmal emphsis on its founding practice.
The authors of the new study write that "… despite the traditional prominence of psychotherapy in psychiatric practice and training, there are indications of a recent decline in the provision of psychotherapy by U.S. psychiatrists …", noting that visits tend to be brief and focused on "… medication management …" and the introduction of "… newer psychotropic medications with fewer adverse effects."
The study authors were Ramin Mojtabai, M.D., Ph.D., M.P.H., then of Beth Israel Medical Center and now of the Johns Hopkins Bloomberg School of Public Health (Baltimore) [N2], and Mark Olfson, M.D., M.P.H., of the Columbia University Medical Center and the New York State Psychiatric Institute (New York) [N3].
Mojtabai and Olfson analyzed trends in psychotherapy provision using data from national surveys of office-based psychiatrist visits from 1996 through 2005.
"This decline coincided with changes in reimbursement, increases in managed care and growth in the prescription of medications," the authors write.
"Psychiatrists who provided psychotherapy to all of their patients relied more extensively on self-pay patients, had fewer managed-care visits and prescribed medications in fewer of their visits compared with psychiatrists who provided psychotherapy less often," the authors write.
"These trends highlight a gradual but important change in the content of outpatient psychiatric care in the United States and a continued shift toward medicalization of psychiatric practice," they conclude.
"A key challenge facing the future generation of psychiatrists will likely involve maintaining their professional role as integrators of the biological and psychosocial perspectives while working within the constraints of the strong market forces of third-party payers and managed care to implement advances in the diagnosis and treatment of mental disorders."
|Last Updated on Monday, 11 August 2008 18:08|