Are psychiatrists' characteristics related to how they care for depression in the medically ill? Results from a national case-vignette survey

被引:22
作者
Epstein, SA
Gonzales, JJ
Weinfurt, K
Boekeloo, B
Yuan, N
Chase, G
机构
[1] Georgetown Univ, Med Ctr, Dept Psychiat, Washington, DC 20007 USA
[2] NIMH, Bethesda, MD 20892 USA
[3] Duke Univ, Ctr Med, Durham, NC USA
[4] Univ Maryland, College Pk, MD USA
[5] Bowling Green State Univ, Bowling Green, OH USA
[6] Henry Ford Hlth Sci Ctr, Detroit, MI USA
关键词
D O I
10.1176/appi.psy.42.6.482
中图分类号
R749 [精神病学];
学科分类号
100205 [精神病与精神卫生学];
摘要
The authors' goal was to examine the relationship between psychiatrists' characteristics and their decisions regarding depression care. A national sampling of 278 psychiatrists answered diagnosis and treatment questions for one of four case vignettes with depression and various degrees of medical comorbidity They also responded to a questionnaire assessing practice and demographic characteristics. Tendency to diagnose major depression was significantly associated with being board certified, being in practice for less time, having a greater percentage of patients with managed care, and having a greater percentage of patients on psychotropic medications. Tendency to recommend an antidepressant was significantly associated with the psychiatrist being male, being less satisfied with practice, and having a greater percentage of patients on psychotropic medications. These findings remained significant even after controlling for case characteristics. Diagnostic and prescribing tendencies of psychiatrists appear to be associated with specific physician characteristics and not simply case characteristics. These findings have implications for further studies of predictors of quality of care.
引用
收藏
页码:482 / 489
页数:8
相关论文
共 23 条
[1]
Byrne S, 1997, PSYCHIAT SERV, V48, P835
[2]
DORWART RA, 1992, AM J PSYCHIAT, V149, P1499
[3]
Practice patterns in the diagnosis and treatment of anxiety and depression in the medically ill - A survey of psychiatrists [J].
Epstein, SA ;
Gonzales, JJ ;
StOnge, J ;
CarterCampbell, J ;
Weinfurt, K ;
Leibole, M ;
Goldberg, RL .
PSYCHOSOMATICS, 1996, 37 (04) :356-367
[4]
Hosmer D. W., 1989, APPL LOGISTIC REGRES, DOI DOI 10.1097/00019514-200604000-00003
[5]
FACTORS ASSOCIATED WITH ANTIDEPRESSANT CHOICE [J].
HUSZONEK, JJ ;
DEWAN, MJ ;
DONNELLY, MP .
PSYCHOSOMATICS, 1995, 36 (01) :42-47
[6]
CLINICAL JUDGMENT IN RHEUMATOID-ARTHRITIS .1. RHEUMATOLOGISTS OPINIONS AND THE DEVELOPMENT OF PAPER PATIENTS [J].
KIRWAN, JR ;
CHAPUTDESAINTONGE, DM ;
JOYCE, CRB ;
CURREY, HLF .
ANNALS OF THE RHEUMATIC DISEASES, 1983, 42 (06) :644-647
[7]
Meredith LS, 1996, ARCH GEN PSYCHIAT, V53, P905
[8]
MEREDITH LS, 1998, 12 INT C MENT HLTH P, P19
[9]
OLFSON M, 1994, AM J PSYCHIAT, V151, P89
[10]
Antidepressant prescribing practices of outpatient psychiatrists [J].
Olfson, M ;
Marcus, SC ;
Pincus, HA ;
Zito, JM ;
Thompson, JW ;
Zarin, DA .
ARCHIVES OF GENERAL PSYCHIATRY, 1998, 55 (04) :310-316