Adequacy of Antidepressant Treatment by Psychiatric Residents: The Antidepressant Treatment History Form as a Possible Assessment Tool

Abstract

Facility in psychopharmacology is a major goal of psychiatric residency. This study assesses the adequacy of pharmacotherapy provided to depressed patients in a resident clinic. Charts of all 285 patients seen in an outpatient triage clinic during 2000 were reviewed. One hundred twelve patients had diagnoses of major depression, dysthymia, depressive disorder not otherwise specified, adjustment disorder with depressed mood, or bipolar disorder with a documented depressed episode during the studied period. Pharmacotherapy prescribed to these 112 patients was rated using the Antidepressant Treatment History Form (ATHF). Also analyzed were weeks in treatment and Clinical Global Impression (CGI) Severity score assigned retrospectively. Of the 112 charts subjected to detailed review, 49.1% documented adequate treatment. Antidepressant Treatment History Form ratings increased with treatment duration. No correlation was found between ATHF ratings and CGI ratings. Results suggest that time retained in treatment is a major factor in treatment adequacy.