This is an application to study how psychiatric practitioners treat depression. To date, the project has surveyed pharmacotherapy experts (American and International), teachers of pharmacotherapy and general psychiatric practitioners with regard to use of antidepressants: i.e., who should get them, who should get which specific one, how should dose be increased, how should medical complications be taken into amount, when is it safe to terminate? In addition, a modification of the psychiatric survey has begun for family practitioners who probably treat more depressed patients than do psychiatrists. A portion of the present application is to complete the family practice survey. The present application is also an expansion of concept from pharmacotherapy to the general treatment of depression, including the psychotherapies. It is assumed that many psychiatrists treat depression with some combination of pharmacotherapy and psychotherapy, although there are some who employ each exclusively. The general questions posed by the survey of psychotherapeutic practices are: (a) What kind of patient is likely to profit from a psychotherapy? (b) What kind of patient is likely to profit from a specific psychotherapy? (c) What techniques have been found to be useful in each type of therapy? (d) How frequent are the sessions and over what duration, (e) How to terminate, and (f) Interaction with drug therapy. As with the survey of pharmacotherapy, we expect areas of agreement and disagreement. The areas of disagreement will serve to highlight issues that require clarification by means of research. Areas of agreement are gratifying in that some critics feel that there is little that psychotherapists can agree on. The documentation of areas of agreement serves to indicate current community practice. Several groups of psychiatrists will be surveyed: (a) Acknowledged experts (American and International) in psychotherapy; (b) Teachers of psychotherapy in accredited psychiatry departments; and (c) General psychiatric practitioners. A probability sample will be selected for each group. Respondents will be interviewed either personally or by phone. Respondents will be compensated in order to enhance cooperation. The survey instrument will be reviewed by the major consultants (Ban, Hollender, Lehmann, and Strupp) and subjected to a pretest on 4-6 other experts before going to the field. The results of this survey will indicate areas of common psychotherapeutic practice and areas of disagreement.
| Goldberg, S C; Tilley, D H; Friedel, R O et al. (1988) Who benefits from tricyclic antidepressants: a survey. J Clin Psychiatry 49:224-8 |
| Goldberg, S C; Tilley, D H; Friedel, R O et al. (1986) A survey of psychiatrists' practices related to the use of tricyclic antidepressants. Hosp Community Psychiatry 37:1247-51 |
