ANTIDEPRESSANT PRESCRIBING PRACTICES OF OUTPATIENT PSYCHIATRISTS

Background: The authors examined recent changes in the number and prop ortion of patients prescribed antidepressants by psychiatrists in outp atient private practice and characterized antidepressant prescription patterns by patient age, sex, race, payment source, and clinical diagn osis. Methods: The authors analyzed physician-reported data from the 1 985 and 1993-1994 National Ambulatory Medical Care Survey, focusing on visits to physicians specializing in psychiatry. Logistic regressions were used to examine associations between survey year and antidepress ant prescription, adjusting for the presence of other variables. Resul ts: The proportion of outpatient psychiatric visits in which an antide pressant was prescribed increased from 23.1% (95% confidence interval [CI], 19.7%-26.5%) in 1985 to 48.6% (95% CI, 47.5%-49.7%) in 1993-1994 . After controlling for several patient variables, psychiatric patient s were approximately 2.3 (95% CI, 1.8-2.9) times more likely to receiv e an antidepressant in 1993-1994 than in 1985. In 1993-1994, selective serotonin reuptake inhibitors accounted for approximately half of the psychiatric visits with an antidepressant prescription. Increases in the rate of antidepressant prescription were particularly evident for children and young adults; whites; new patients; and patients with adj ustment disorders, personality disorder, depression not otherwise spec ified or dysthymia, and some anxiety disorders. Conclusions: During th e late 1980s and early 1990s, there was a significant increase in the prescription of antidepressants by office-based psychiatrists. This in crease was greatest for patients with less severe psychiatric disorder s.