Psychotropic Drug Use in Family Practice*

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Abstract
In an attempt to assess the precision of an illness-treatment “fit” between dispensing and actual need for psychotropic medications, the present study examined the dispensing patterns to consecutive attenders of private general practice. “Conservative” use of psychotropic drugs was indicated insofar as patients were seldom dispensed medication in the absence of emotional problems, and the presence of emotional problems frequently was not accompanied by the dispensing of medication. In addition, specific social and illness factors were located which could differentially predict either the presence of emotional problems, the use of psychotropic drugs, or both of these variables. The potential for constructing a more precise illness-treatment fit was considered. * Data were collected in the offices of private family practitioners in the Philadelphia area. This work was supported by USPHS Grants MH-08957-8; The authors wish to express their gratitude to Drs. Clark, Perloff, Rial, Rosenfeld, Segal, and Zamostien, members of the Private Practice Research Group who participated in the data collection phase of the study; and to Miss Reita Brandt and Mrs. Alice Randall, programmers, for their active role in the data handling of the study. ** Dr. Hesbacher is Assistant Professor of Sociology, Department of Psychiatry, University of Pennsylvania, and Research Associate, Philadelphia General Hospital. Mr. Stepansky is a Doctoral Candidate in History, Yale University. Dr. Stepansky is Assistant Professor of Clinical Medicine, Jefferson Medical College, and a member of the Private Practice Research Group. Dr. Rickels is Professor of Psychiatry and Pharmaceutiques, University of Pennsylvania, and Director of the Psychopharmacology Research Unit, Philadelphia General Hospital Die folgende Studie untersucht die Verschreibungsgewohnheiten von 7 praktischen Ärzten in Philadelphia. Das Ziel der Studie war, zu klären, welche Patienten angemessen behandelt wurden, d.h. nur dann Psychopharmaka verschrieben bekamen, wenn sie erkennbare emotionelle Symptome hatten, und welcher Prozentsatz von Patienten nicht richtig behandelt wurde, d.h. Psychopharmaka erhielt, ohne Anzeichen von emotionellen Störungen zu haben. Die Untersuchung wurde an über 1.100 Patienten durchgeführt und zeigt eindeutig, daß alle 7 praktischen Ärzte sehr zurückhaltend in dem Verschreiben von Psychopharmaka waren. 50 % aller Patienten, die unter zumindest leichten emotionellen Symptomen litten, erhielten niemals ein Psychopharmakon. Es wurden verschiedene demographische und Krankheits-Faktoren eruiert, die zwischen Patienten mit und ohne emotionelle Symptome sowie Patienten mit und ohne Psychopharmaka-Verschreibung differenzierten.

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