Choice of antipsychotic treatment by European psychiatry trainees: are decisions based on evidence?

BMC Psychiatry

Umberto Volpe^1,15  Rajeev Krishnadas⁴  Neil Masson^1,11  Raphael Psaras⁶  Alexander Nawka⁷  Izu Nwachukwu^1,12  Florian Riese^1,13  Jeroen Van Zanten⁸  Nele De Vriendt²  Costin Roventa⁹  Iolanda Dumitrescu⁹  Luis Mendonca^1,14  João Gama Marques³  Greg Lydall^1,10  Olivier Andlauer^1,16  Sinan Guloksuz⁵  Sameer Jauhar¹ 

[1] Chair, EFPT Research Group, Sackler Institute for Psychobiological Research, Institute of Neurological Sciences, Southern General Hospital, 2nd Floor 1345 Govan Rd, Glasgow G51 4TF, UK;Openbaar Psychiatrisch Zorgcentrum Rekem, Rekem, Belgium;Centro Hospitalar Psiquiátrico de Lisboa, Psychiatry Educator at Faculdade de Medicina de Lisboa, Lisboa, Portugal;Sackler Institute for Psychobiological Research,, Institute of Neurological Sciences, Southern General Hospital, 2nd Floor 1345 Govan Rd, Glasgow G514TF, UK;Department of Psychiatry and Psychology, Maastricht University Medical Centre, P.O. Box 616, 6200, MD Maastricht, The Netherlands;1st Psychiatric Department, Psychiatric Hospital of Attica, 374, Athinon avenue, 12462 Athens, Greece;Department of Psychiatry, 1st Faculty of Medicine, Charles University in Prague, Ke Karlovu 11, 128 00 Praha 2, Prague, Czech Republic;Department of Psychiatry, Neuroscience Campus Amsterdam, VU Medical Center, Amsterdam, the Netherlands;Hospital Pr Dr Al Obregia, Bucharest, Romania;Department of Molecular Psychiatry, Mental Health Sciences, University College London, London W1T 4JF, UK;Wishaw Resource Centre, 48-54 Roberts Street, Wishaw, ML2 7JF, UK;St Vincent's University Hospital, Dublin 4, Ireland;Psychiatric University Hospital Zurich, Zurich, Switzerland;Centro Hospit alar Psiquiatrico de Lisboa, Lisboa, Portugal;Department of Psychiatry, University of Naples - SUN Largo Madonna delle Grazie, 80138 Napoli, Italy;EA 481 Laboratoire de Neurosciences, University of Franche-Comte, and Department of Clinical Psychiatry, University Hospital of Besancon, F-25030 Besancon, France

关键词: Treatment;    Psychosis;    Psychotherapy;    Efficacy;    Decision-making;    Evidence-based medicine;    Psychiatry trainees;    Drug therapy;    Antipsychotics;   

Others  :  1124404
DOI  :  10.1186/1471-244X-12-27

 received in 2011-05-19, accepted in 2012-03-30,  发布年份 2012

【 摘 要 】

Background

Little is known about the factors influencing treatment choice in psychosis, the majority of this work being conducted with specialists (consultant) in psychiatry. We sought to examine trainees' choices of treatment for psychosis if they had to prescribe it for themselves, their patients, and factors influencing decision-making.

Methods

Cross-sectional, semi-structured questionnaire-based study.

Results

Of the 726 respondents (response rate = 66%), the majority chose second-generation antipsychotics (SGAs) if they had to prescribe it for themselves (n = 530, 93%) or for their patients (n = 546, 94%). The main factor influencing choice was perceived efficacy, 84.8% (n = 475) of trainees stating this was the most important factor for the patient, and 77.8% (n = 404) stating this was the most important factor for their own treatment. Trainees with knowledge of trials questioning use of SGAs (CATIE, CUtLASS, TEOSS) were more likely to choose second-generation antipsychotics than those without knowledge of these trials (χ² = 3.943; p = 0.047; O.R. = 2.11; 95% C.I. = 1.0-4.48). Regarding psychotherapy, cognitive behavioural therapy (CBT) was the most popular choice for self (33.1%; n = 240) and patient (30.9%; n = 224). Trainees were significantly more likely to prefer some form of psychotherapy for themselves rather than patients (χ² = 9.98; p < 0,002; O.R. = 1.54; 95% CIs = 1.18-2.0).

Conclusions

Trainees are more likely to choose second-generation antipsychotic medication for patients and themselves. Despite being aware of evidence that suggests otherwise, they predominantly base these choices on perceived efficacy.

【 授权许可】

   
2012 Jauhar et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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