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Trends in office-based mental health care provided by psychiatrists and primary care physicians

机译：精神科医生和初级保健医生提供的基于办公室的心理保健趋势

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Objective:To assess recent national trends in mental health care provided by office-based psychiatrists and primary care physicians. Method:Trends in mental health-related visits to psychiatrists and primary care physicians are evaluated with the 1995-2010 National Ambulatory Medical Care Surveys. Rates and percentages of visits with mental health complaints, mental disorder diagnoses, psychotropic medications, and psychotherapy or mental health counseling were calculated for 1995-1998,1999-2002,2003-2006, and 2007-2010 by dividing the number of visits of a given type by intercensal population estimates. Results: Between 1995-1998 and 2007-2010, a significant increase occurred in the rate per 100 population of primary care visits with mental health complaints (5.96 to 8.49) (OR = 0.45; 95% Cl, 0.33-0.62, mental disorders (8.75 to 13.23) (OR= 1.40; 95% Cl, 1.26-1.56), and psychotropic medications (11.08 to 26.74) (OR=3.43; 95% Cl, 2.16-2.71). Significant corresponding increases occurred in psychiatrist visits with psychotropic medications (5.28 to 7.85) (OR = 2.25; 95% Cl, 1.49-3.41), but not mental disorders (7.60 to 8.95) (OR = 0.87; 95% Cl, 0.34-2.23), and the rate with mental health complaints significantly declined (5.87 to 5.20) (OR = 0.45; 95% Cl, 0.33-0.62). During this period, the percentages of visits to primary care physicians that included prescriptions for antidepressants (interaction P=.0001), antipsychotics (interaction P=.O3), and anxiolytics/hypnotics (interaction P=.0009) increased significantly faster than the corresponding percentages of visits to psychiatrists. A similar pattern occurred for visits that resulted in a bipolar disorder diagnosis (interaction P=.01). Conclusions: In recent years, office-based primary care physicians have significantly increased their involvement in providing mental health care. These trends underscore the importance of collaboration between primary care physicians and psychiatrists to help ensure provision of high quality outpatient mental health care.
机译：目的：评估办公室精神病医生和初级保健医生在精神保健方面的近期全国趋势。方法：1995-2010年全国非住院医疗护理调查对与精神科医生和基层医疗医生进行的心理健康相关访视的趋势进行了评估。通过将1995年至1998年，1999年至2002年，2003年至2006年以及2007年至2010年的精神病投诉，精神障碍诊断，精神药物，心理治疗或精神健康咨询的访视率和百分比计算为根据调查人口的特定类型。结果：在1995-1998年至2007-2010年期间，每100名有精神健康投诉的初级保健就诊率显着提高（5.96至8.49）（OR = 0.45; 95％Cl，0.33-0.62，精神障碍（ 8.75至13.23）（OR = 1.40; 95％Cl，1.26-1.56）和精神药物（11.08至26.74）（OR = 3.43; 95％Cl，2.16-2.71）。 （5.28至7.85）（OR = 2.25; 95％Cl，1.49-3.41），但不是精神障碍（7.60至8.95）（OR = 0.87; 95％Cl，0.34-2.23），并且对心理健康投诉的比率显着下降（5.87至5.20）（OR = 0.45; 95％Cl，0.33-0.62）。在此期间，包括抗抑郁药处方（交互作用P = .0001），抗精神病药（交互作用P = .O3）和抗焦虑药/催眠药（相互作用P = .0009）的增长速度明显快于相应的精神科医师就诊百分比。导致双相障碍诊断的就诊时出现了类似的双眼模式（交互作用P = .01）。结论：近年来，以办公室为基础的初级保健医生大大增加了他们在提供精神保健方面的投入。这些趋势强调了初级保健医生和精神科医生之间合作的重要性，以帮助确保提供高质量的门诊精神保健服务。

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