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Cited by 133Mental Health Treatment and AccessPrimary Care and Health OutcomesAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The Prescribing of Psychotropic Drugs by Primary Care Physicians: an International Collaborative Study

Linden, Michael, Lecrubier, Yves, Bellantuono, Cesario, Benkert, Otto, Kisely, Steve, Simon, Gregory·1999·Journal of Clinical Psychopharmacology
DOI 10.1097/00004714-199904000-00007
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Abstract

Psychotropic drugs play a major role in primary care management of mental disorders. This study expands the existing data on prescribing practices using data from a 15-center, primary care epidemiologic survey. Questions to be addressed include the following: Which clinical and nonclinical factors are related to the prescribing of psychotropic drugs by primary care physicians? How do prescribing patterns vary across primary care centers? At each center, primary care patients were screened using the General Health Questionnaire, and a stratified random sample completed a standardized diagnostic assessment. For each patient completing the diagnostic assessment, the treating primary care physician provided data on clinical diagnosis and medications prescribed. Study results indicated that 11.5% of all practice attenders, 51.7% of cases who received a diagnosis of mental disorders by a physician, and 27.6% of cases who received a diagnosis using the Composite International Diagnostic Interview were treated with psychotropic medication because of their psychologic problems. Anxiolytics, hypnotics, and antidepressants each accounted for approximately 20% of all prescriptions. Prescription rates increased with the prominence of psychologic complaints, severity of mental disorder, severity of social disability, female gender, age older than 40 years, lower education, unemployment, and marital separation. Rates and type of drugs also varied among specific mental disorders; 19.3% of patients with brief recurrent depression but 55.0% with agoraphobia got any psychotropic drug. Antidepressant drugs were prescribed in 7.7% of anxiety disorders compared with 31.9% of depressive disorders. There were large differences between international centers. When comparing client-type centers with clinic-type centers, overall prescription rates were similar (51.2 vs. 52.9%), but significant differences were observed with respect to psychotropic polypharmacy (12.6% client, 6.3% clinic), tranquilizer medication (24.2 client, 32.9% clinic), and antidepressant medication (17.3 client, 8.9% clinic). Psychotropic drugs have an important role in the treatment of mental disorders by general practitioners. Prescription is associated with a number of clinical but also nonclinical factors that must be recognized when guidelines for international use are to be published. Recognition of mental disorders and selection of specific drug classes are important areas in which medical practice needs improvement.

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Crossref · 10.1097/00004714-199904000-00007

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Authors
Linden, M., Lecrubier, Y., Bellantuono, C., Benkert, O., Kisely, S., & Simon, G.
Affiliations
University of Verona (IT)
ORCID
Venue
Journal of Clinical Psychopharmacology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1999-04
Volume
19
Issue
2
Pages
132-140
ISSN
0271-0749 (ISSN-L)
DOI
10.1097/00004714-199904000-00007
OpenAlex
W2024970519
Cited by
133
References
43
Citations by year
2025: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 5 · 2014: 3 · 2013: 7 · 2012: 7
FWCI
8.43
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Psychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
psychotropic prescribing, primary care physicians, mental illness, antidepressants, anxiolytics, hypnotics, psychotropic polypharmacy, depression, anxiety disorders, agoraphobia, social dysfunction, prescribing patterns, general practitioners
MeSH terms
Adult, Anxiety Disorders, Depressive Disorder, Female, Humans, Male, Middle Aged, Practice Patterns, Physicians', Physicians, Family, Drug Prescriptions, Psychotropic Drugs

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