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Non-pharmacological treatment of psychiatrists in addition to the prescribing of an antidepressant drug

Published online by Cambridge University Press:  07 May 2007

M. Linden ,
W. Dierkes  and
T. Munz
M. Linden*
Affiliation:
Research Group Psychosomatic Rehabilitation at the Charité, University Medicine Berlin, Germany Rehabilitation Centre Seehof, Teltow, Germany
W. Dierkes
Affiliation:
Medical Department, Wyeth Pharma GmbH, Münster, Germany
T. Munz
Affiliation:
Medical Department, Wyeth Pharma GmbH, Münster, Germany
*
∗Corresponding author. Research Group Psychosomatic Rehabilitation, Rehabilitation Center Seehof, Lichterfelder Allee 55, 14513 Teltow, Germany. Tel.: +49 03328 345678; fax: +49 03328 345555. E-mail address:michael.linden@charite.de (M. Linden).
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Abstract

Background

Guidelines for the treatment of depression regularly emphasize that pharmacotherapy of depression should be accompanied by supportive counseling and other psychotherapeutic interventions. It is unknown which role psychiatrists in routine care give to such verbal therapies.

Methods

in a drug utilization study of venlafaxine, psychiatrists in private practice and in hospitals were asked to tell what non-pharmacological therapies they saw as an important part of the treatment of the present depressive episode. Additionally patient characteristics, treatment variables, setting characteristics and physician characteristics were assessed.

Results

Psychiatrists reported some kind of verbal therapies in 19.0% of outpatients and 36.8% of inpatients. Verbal therapies were reported more often for younger patients, who got more double diagnoses and were more severely ill. Patients with verbal therapies got more psychotropic medication. in the inpatient setting verbal therapies were related to generally more treatment overall and a higher rate of treatment response. in both treatment settings verbal therapies were related to lower rates of discontinuation of the antidepressant.

Conclusion

Verbal interactions are part of any patient–physician encounter and should be theory guided as part of the therapeutic process in the treatment of depressive disorders. Under this assumption the rate of patients for which psychiatrists reported some kind of verbal therapy as explicit part of their treatment could be higher. More research is needed on patient guidance, counseling and supportive psychotherapy in psychiatry.

Keywords

antidepressant drugsDepressionVenlafaxinePsychotherapyCounselingPatient guidance
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 7 , October 2007 , pp. 419 - 426
Copyright
Copyright © Elsevier Masson SAS 2007

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