PRACTICE PATTERNS IN THE DIAGNOSIS AND TREATMENT OF ANXIETY AND DEPRESSION IN THE MEDICALLY ILL - A SURVEY OF PSYCHIATRISTS

By use of a survey that assessed practice patterns and responses to ca se vignettes of anxiety and depression in the medically ill, 38 psychi atrists were compared with 10 national leaders in consultation-liaison psychiatry. On the case vignettes, percentage agreement with the expe rts varied significantly by case and by question. Fifty-eight percent of the time the psychiatrists agreed with the experts on whether to or der laboratory tests as compared with an 81% agreement level on whethe r to use psychotherapy. Multiple regression analysis revealed that the best model to predict lower agreement with the experts was years in p ractice plus percentage of time spent in solo (vs. group) practice (r( 2) = 0.40). This study extended previous data-based pharmacoepidemiolo gy by assessing multiple aspects of psychiatrists' practice patterns. Psychiatrists who are more distant from training years and more isolat ed from the current stimulation of colleagues may be particularly appr opriate targets for continuing education.