Bodkin J A, Klitzman R L, Pope H G
McLean Hospital, Consolidated Department of Psychiatry, Harvard Medical School, Belmont, Massachusetts 02178, USA.
J Nerv Ment Dis. 1995 Dec;183(12):729-35. doi: 10.1097/00005053-199512000-00001.
We present data showing the degree to which a "biological-psychotherapeutic" division persists in American psychiatry, and how psychiatrists' treatment orientation is associated with personal and professional characteristics. Almost two thirds of academic psychiatrists who responded to our survey (N = 435) could be classified as either biological (27%) or psychotherapeutic (37%) in orientation, according to the proportion of their caseload to which they provided psychotherapy (< or = 25% vs. > 75%). There appears to have been an increase over the last 35 years in the proportion of psychiatrists who can be classified as biologically oriented and a decrease in the proportion who can be classified as psychotherapeutically oriented, as well as the emergence of a large class of intermediate or "eclectic" practitioners (36%). Several personal and professional attributes were distributed differentially according to treatment orientation. Psychotherapeutically oriented respondents more frequently reported personal histories of psychiatric disorders than did biologically oriented respondents (64% vs. 39%) as well as greater satisfaction with clinical work (81% vs. 53% "very satisfied"). Differences were also found in age, gender, history of personal psychotherapy, family history of psychiatric disorder, history of marijuana use, degrees of involvement in research, teaching and clinical care of patients, and overall work satisfaction, as well as other characteristics.
我们展示的数据表明了“生物-心理治疗”划分在美国精神病学领域持续存在的程度,以及精神科医生的治疗取向如何与个人和职业特征相关联。根据我们调查中回复的学术精神科医生(N = 435)为其病例提供心理治疗的比例(<或= 25%与> 75%),几乎三分之二的医生可以被归类为生物取向(27%)或心理治疗取向(37%)。在过去35年里,可归类为生物取向的精神科医生比例似乎有所增加,可归类为心理治疗取向的比例有所下降,同时还出现了一大类中间或“折衷”的从业者(36%)。一些个人和职业属性根据治疗取向的不同而有所分布。与生物取向的受访者相比,心理治疗取向的受访者更频繁地报告有精神疾病的个人病史(64%对39%),以及对临床工作更高的满意度(81%对53%“非常满意”)。在年龄、性别、个人心理治疗史、精神疾病家族史、大麻使用史、参与患者研究、教学和临床护理的程度、总体工作满意度以及其他特征方面也发现了差异。