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Trends in office-based psychiatric practice.

M Olfson1, S C Marcus, H A Pincus

  • 1New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, NY 10032, USA.

The American Journal of Psychiatry
|March 18, 1999
PubMed
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Psychiatric visits shortened and focused more on medication prescriptions than psychotherapy between 1985 and 1995. These trends in office-based psychiatric practice may reflect changes in financial incentives and new drug treatments.

Area of Science:

  • Psychiatry
  • Health Services Research

Background:

  • Office-based psychiatric practice is a key component of mental healthcare delivery.
  • Understanding trends in psychiatric visit characteristics is crucial for evaluating healthcare quality and resource allocation.

Purpose of the Study:

  • To analyze changes in the duration and composition of psychiatric visits over a decade (1985-1995).
  • To identify trends in psychotherapy and medication prescription during psychiatric consultations.

Main Methods:

  • Analysis of physician-reported data from the National Ambulatory Medical Care Surveys (1985 and 1995).
  • Focus on visits to psychiatrists in office-based practice.
  • Assessment of secular changes in visit duration and treatment modalities.

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Main Results:

  • Psychiatric visits became shorter and less frequently included psychotherapy from 1985 to 1995.
  • The proportion of visits including medication prescriptions increased.
  • Shorter visit durations were observed for younger patients, those with private insurance, and patients not receiving psychotropic medication.

Conclusions:

  • Shifting practice styles in psychiatry may be influenced by evolving financial structures.
  • The advent of new pharmacologic treatments likely contributed to observed changes in visit composition and duration.