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.
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ABSTRACT: This study utilized a large clinical dataset of patients representative of those in routine U.S. psychiatric practice to assess the influence of sociodemographic variables and diagnostic class on health plan membership (public or private). Data on patients with schizophrenia or other psychotic disorders (n=288) and patients with mood or anxiety disorders (n=1304) were obtained from a cross-sectional practice-based survey conducted by the American Psychiatric Institute for Research and Education. The likelihood of health plan membership was lower among males and among those from a minority race/ethnicity. Health plan membership was also affected by educational attainment and employment status. Even after controlling for these sociodemographic determinants of health plan membership, individuals with schizophrenia/other psychotic disorders were significantly less likely to belong to a health plan than those with mood/anxiety disorders.Community Mental Health Journal 05/2006; 42(2):197-204. DOI:10.1007/s10597-005-9016-5 · 1.03 Impact Factor
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ABSTRACT: Treatments in multiple settings are very common in the management of borderline personality disorder (BPD). The potential of multiple setting treatment is such that it is recognised in the American Psychiatric Associations proposed treatment guidelines for BPD. The general consensus of clinicians on the importance of using different therapists and different settings simultaneously in treating patients with BPD is not supported by a unifying theoretical model explaining the specific effects of multiple therapist-multi-setting approach in treating BPD. This paper provides an attachment theory-based possible theoretical explanation of why a patient with BPD could benefit from simultaneous relationships with more than one therapist. According to our hypothesis, the complex relational configuration created by the simultaneous presence of therapists working in different settings may constitute an ideal basis to prevent or correct some of the consequences of disorganised attachment which are present in BPD. Such consequences are likely to result in an unstable or unfruitful relationship for both the patient and therapist.