A cross-national study of drug treatment decisions in psychiatry

It is generally believed that American psychiatrists prescribe higher doses of psychoactive drugs than do European psychiatrists. This belief is based on cross-national studies that compared different groups of psychiatrists treating different patients, thus confounding patient and physician variables. An experimental approach derived from cognitive psychology was used to present identical patient material to a group of American psychiatrists and to two groups of Swiss psychiatrists. Cross-national differences were confirmed--the Americans prescribed much higher doses than the Swiss. Considerable differences in doses prescribed were also found between the two Swiss groups. Neither group was very consistent in prescribing. Agreement about choice of drug among psychiatrists in all three groups was low; agreement among the Americans was not above chance.