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Robert A. Rosenheck - One of the best experts on this subject based on the ideXlab platform.
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initiation of new psychotropic prescriptions without a Psychiatric Diagnosis among us adults rates correlates and national trends from 2006 to 2015
Health Services Research, 2019Co-Authors: Taeho Greg Rhee, Robert A. RosenheckAbstract:OBJECTIVES To estimate rates and national trends of initiation of new psychotropic medications without a Psychiatric Diagnosis and to identify demographic and clinical correlates independently associated with such use among US adults in outpatient settings. DATA SOURCE Data were gathered from the 2006-2015 National Ambulatory Medical Care Survey (NAMCS), a nationally representative sample of office-based U.S. outpatient care. The sample was limited to adults aged 18 or older who received a new psychotropic drug prescription (n = 8618 unweighted). STUDY DESIGN Using a repeated cross-sectional design with survey sampling techniques, we estimated prescription initiation rates and national trends. Multivariable-adjusted logistic regression analysis was used to identify correlates independently associated with initiation of new psychotropic prescriptions without a Psychiatric Diagnosis. DATA COLLECTION/EXTRACTION METHODS Data were publicly available, and we extracted them from the Centers for Disease Control and Prevention website. PRINCIPAL FINDINGS Altogether, at 60.4% of visits at which a new psychotropic prescription was initiated, no Psychiatric Diagnosis was recorded for the visit. Overall, the rate increased from 59.1% in 2006-2007 to 67.7% in 2008-2009 and then decreased to 52.0% in 2014-2015. Visits to psychiatrists were associated with very low odds of having no Psychiatric Diagnosis when compared to primary care visits (OR = 0.02; 95% CI, 0.01-0.04). Visits to non-Psychiatric specialists showed 6.90 times greater odds of not having a Psychiatric Diagnosis when compared to primary care visits (95% CI, 5.38-8.86). CONCLUSION New psychotropic medications are commonly initiated without any Psychiatric Diagnosis, especially by non-psychiatrist physicians. Non-psychiatrists should document relevant diagnoses more vigilantly to prevent potentially inappropriate use or misuse.
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Prescribing of psychotropic medications to patients without a Psychiatric Diagnosis.
Psychiatric Services, 2013Co-Authors: Ilse R. Wiechers, D. Leslie, Robert A. RosenheckAbstract:ObjectiveThis study used a private insurance claims database to examine the use of diverse classes of psychotropic medications among patients without a Psychiatric Diagnosis.MethodsMarketScan claims data for 2009 were used to identify privately insured individuals who filled a prescription for at least one psychotropic medication (5.1 million patients). Bivariate and multivariate analyses were used to compare the proportion of patients with and without a Psychiatric Diagnosis who received a prescription for six different classes of psychotropic medications. The analyses were adjusted for potential medical indications and severity of comorbid general medical illness.ResultsAltogether, 58% of individuals who were prescribed a psychotropic medication in 2009 had no Psychiatric Diagnosis during the year. The proportion of patients who were prescribed a psychotropic medication without a Psychiatric Diagnosis was highest among individuals aged 50 to 64 (69%) and among individuals who did not receive any mental ...
Sean H. Yutzy - One of the best experts on this subject based on the ideXlab platform.
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Goodwin and Guze's Psychiatric Diagnosis 7th Edition - Evolution of Psychiatric Diagnosis
Goodwin and Guze's Psychiatric Diagnosis 7th Edition, 2018Co-Authors: Carol S. North, Sean H. YutzyAbstract:This chapter considers the evolution of Psychiatric Diagnosis in the United States at length, with references to earlier European contributions. It reviews the medical model in psychiatry movement by the Washington University, St. Louis group in the United States to develop Psychiatric Diagnosis validity parameters and reliable criteria sets to facilitate communication, research, and clinical application for the major mental illnesses. Challenges to this model are considered and ultimate scientific solidification in DSM-III is reviewed. Over time (33 years), dissent and the continual failure to discover a neurobiological basis for any major Psychiatric illness have placed a strain on the medical diagnostic process, and these controversies are reviewed at length. Outlined are the reasons that psychiatry should remain resolute in endorsing what we know scientifically instead of what expert consensus constructs.
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Goodwin and Guze's Psychiatric Diagnosis 7th Edition
2018Co-Authors: Carol North, Sean H. YutzyAbstract:Well known for providing a thorough yet concise view of the natural history of Psychiatric disorders, this popular text has been newly updated chapter by chapter in this seventh edition. As in previous editions, each chapter systematically covers the definition, historical background, epidemiology, clinical picture, natural history, complications, family studies, differential Diagnosis, and clinical management of each disorder. Terminology has been updated for consistency with changes made in DSM-5. Recent epidemiological and neurobiological findings are provided, including the long-term course of mood disorders, genetics and neuroimaging of schizophrenia and mood and other disorders, cognitive changes in relation to depression and dementia, brain stimulation techniques, outcome studies of eating disorders, and epidemiology of substance use disorders. This edition reaffirms the importance of careful Psychiatric Diagnosis as the essential foundation for treatment decisions. No other text provides such a lucid, well-documented and critically sound overview of the major syndromes in psychiatry. Medical students, Psychiatric residents, and other students will continue to find Psychiatric Diagnosis a unique guide to the field.
A T F Beekman - One of the best experts on this subject based on the ideXlab platform.
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Psychiatric Diagnosis: Personalised by definition Psychiatrische diagnostiek: Per definitie gepersonaliseerd
Tijdschrift voor psychiatrie, 2018Co-Authors: M W Hengeveld, A T F BeekmanAbstract:textabstractBACKGROUND: Personalised psychiatry requires a Psychiatric Diagnosis which aims to determine the causes of the mental disorder and the context within which it has developed, including the factors of most importance for the choice of an appropriate treatment. AIM To show that Psychiatric Diagnosis is personalised by definition. method Description of the differences between Psychiatric classification and Psychiatric Diagnosis, including a discussion of symptom network Diagnosis and Diagnosis of meaningful connections. results It appears from references from classical and recent Psychiatric textbooks and from the recent Dutch Guideline for Psychiatric evaluation that Psychiatric Diagnosis, different from classification, has always been aimed at determining both biological and psychosocial etiological and pathogenic factors and factors influencing the course and the treatment of the disorder. conclusion: A personalised approach in psychiatry may lead toa direly necessary reappraisal of Psychiatric Diagnosis that is not limited to the classification of symptoms, but that aims specifically towards explaning and understanding mental illness.
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Psychiatric Diagnosis: personalised by definition
Tijdschrift voor psychiatrie, 2018Co-Authors: M W Hengeveld, A T F BeekmanAbstract:Background Personalised psychiatry requires a Psychiatric Diagnosis which aims to determine the causes of the mental disorder and the context within which it has developed, including the factors of most importance for the choice of an appropriate treatment. Aim To show that Psychiatric Diagnosis is personalised by definition. Method Description of the differences between Psychiatric classification and Psychiatric Diagnosis, including a discussion of symptom network Diagnosis and Diagnosis of meaningful connections. Results It appears from references from classical and recent Psychiatric textbooks and from the recent Dutch Guideline for Psychiatric evaluation that Psychiatric Diagnosis, different from classification, has always been aimed at determining both biological and psychosocial etiological and pathogenic factors and factors influencing the course and the treatment of the disorder. Conclusion A personalised approach in psychiatry may lead to a direly necessary reappraisal of Psychiatric Diagnosis that is not limited to the classification of symptoms, but that aims specifically towards explaning and understanding mental illness.
Taeho Greg Rhee - One of the best experts on this subject based on the ideXlab platform.
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initiation of new psychotropic prescriptions without a Psychiatric Diagnosis among us adults rates correlates and national trends from 2006 to 2015
Health Services Research, 2019Co-Authors: Taeho Greg Rhee, Robert A. RosenheckAbstract:OBJECTIVES To estimate rates and national trends of initiation of new psychotropic medications without a Psychiatric Diagnosis and to identify demographic and clinical correlates independently associated with such use among US adults in outpatient settings. DATA SOURCE Data were gathered from the 2006-2015 National Ambulatory Medical Care Survey (NAMCS), a nationally representative sample of office-based U.S. outpatient care. The sample was limited to adults aged 18 or older who received a new psychotropic drug prescription (n = 8618 unweighted). STUDY DESIGN Using a repeated cross-sectional design with survey sampling techniques, we estimated prescription initiation rates and national trends. Multivariable-adjusted logistic regression analysis was used to identify correlates independently associated with initiation of new psychotropic prescriptions without a Psychiatric Diagnosis. DATA COLLECTION/EXTRACTION METHODS Data were publicly available, and we extracted them from the Centers for Disease Control and Prevention website. PRINCIPAL FINDINGS Altogether, at 60.4% of visits at which a new psychotropic prescription was initiated, no Psychiatric Diagnosis was recorded for the visit. Overall, the rate increased from 59.1% in 2006-2007 to 67.7% in 2008-2009 and then decreased to 52.0% in 2014-2015. Visits to psychiatrists were associated with very low odds of having no Psychiatric Diagnosis when compared to primary care visits (OR = 0.02; 95% CI, 0.01-0.04). Visits to non-Psychiatric specialists showed 6.90 times greater odds of not having a Psychiatric Diagnosis when compared to primary care visits (95% CI, 5.38-8.86). CONCLUSION New psychotropic medications are commonly initiated without any Psychiatric Diagnosis, especially by non-psychiatrist physicians. Non-psychiatrists should document relevant diagnoses more vigilantly to prevent potentially inappropriate use or misuse.
M W Hengeveld - One of the best experts on this subject based on the ideXlab platform.
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Psychiatric Diagnosis: Personalised by definition Psychiatrische diagnostiek: Per definitie gepersonaliseerd
Tijdschrift voor psychiatrie, 2018Co-Authors: M W Hengeveld, A T F BeekmanAbstract:textabstractBACKGROUND: Personalised psychiatry requires a Psychiatric Diagnosis which aims to determine the causes of the mental disorder and the context within which it has developed, including the factors of most importance for the choice of an appropriate treatment. AIM To show that Psychiatric Diagnosis is personalised by definition. method Description of the differences between Psychiatric classification and Psychiatric Diagnosis, including a discussion of symptom network Diagnosis and Diagnosis of meaningful connections. results It appears from references from classical and recent Psychiatric textbooks and from the recent Dutch Guideline for Psychiatric evaluation that Psychiatric Diagnosis, different from classification, has always been aimed at determining both biological and psychosocial etiological and pathogenic factors and factors influencing the course and the treatment of the disorder. conclusion: A personalised approach in psychiatry may lead toa direly necessary reappraisal of Psychiatric Diagnosis that is not limited to the classification of symptoms, but that aims specifically towards explaning and understanding mental illness.
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Psychiatric Diagnosis: personalised by definition
Tijdschrift voor psychiatrie, 2018Co-Authors: M W Hengeveld, A T F BeekmanAbstract:Background Personalised psychiatry requires a Psychiatric Diagnosis which aims to determine the causes of the mental disorder and the context within which it has developed, including the factors of most importance for the choice of an appropriate treatment. Aim To show that Psychiatric Diagnosis is personalised by definition. Method Description of the differences between Psychiatric classification and Psychiatric Diagnosis, including a discussion of symptom network Diagnosis and Diagnosis of meaningful connections. Results It appears from references from classical and recent Psychiatric textbooks and from the recent Dutch Guideline for Psychiatric evaluation that Psychiatric Diagnosis, different from classification, has always been aimed at determining both biological and psychosocial etiological and pathogenic factors and factors influencing the course and the treatment of the disorder. Conclusion A personalised approach in psychiatry may lead to a direly necessary reappraisal of Psychiatric Diagnosis that is not limited to the classification of symptoms, but that aims specifically towards explaning and understanding mental illness.
