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[全科医生的精神病学培训与精神药物处方。2. 医生对心理治疗培训的态度及其处方范围]

[General practitioners' training in psychiatry and prescription of psychotropic drugs. 2. Attitudes of physicians to training in psychotherapy and the extent of their prescriptions].

作者信息

Holm M

机构信息

Institut for Almen Medicin, Aarhus Universitet.

出版信息

Ugeskr Laeger. 1990 Aug 6;152(32):2288-90.

PMID:1975962
Abstract

The object of this investigation was to describe and analyse differences in psychiatric training and attitudes to and employment of psychotropic drugs among general practitioners with and without training in psychotherapy, respectively. The investigation was carried out as a multicentre questionnaire investigation in the County of Aarhus with participation of 192 out of 215 (89%) doctors who were invited. Thirty-nine of the participating general practitioners (20%) had participated in a supervised course in psychoanalytically orientated psychotherapy. Doctors who were trained in psychotherapy had more rarely had appointments in psychiatric departments than other doctors. Doctors trained in psychotherapy prescribed fewer benzodiazepines than other doctors (p less than 0.05) and there was psychotherapy chose psychotherapy more frequently (p = 0.02) and more rarely tendency to a lower total prescription of psychotropic drugs. Doctors trained in a psychotropic drugs (p = 0.004) than doctors without this training as treatment for patients with psychosocial conflicts and they more rarely chose psychotropic drugs to supplement psychotherapy (p less than 0.0001). It is concluded that one of the ways of reducing the massive use of psychotropic drugs in Denmark is to improve general practitioners' training in psychotherapy.

摘要

本调查的目的是分别描述和分析接受过心理治疗培训和未接受过心理治疗培训的全科医生在精神科培训、对精神药物的态度及使用方面的差异。该调查作为一项多中心问卷调查在奥胡斯郡开展,215名受邀医生中有192名(89%)参与。39名参与调查的全科医生(20%)参加过以精神分析为导向的心理治疗的督导课程。接受过心理治疗培训的医生在精神科病房坐诊的次数比其他医生少。接受过心理治疗培训的医生开具的苯二氮䓬类药物比其他医生少(p<0.05),且心理治疗培训的医生更倾向于选择心理治疗(p = 0.02),精神药物总处方量较低的趋势更明显。接受过心理治疗培训的医生比未接受过培训的医生更常选择心理治疗作为治疗社会心理冲突患者的方法(p = 0.004),且他们更少选择精神药物来辅助心理治疗(p<0.0001)。研究得出结论,减少丹麦大量使用精神药物的方法之一是改善全科医生在心理治疗方面的培训。

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