Comparative survey of psychiatrists' treatment preferences: California and New York

Abstract

Four hundred thousand of the estimated 17 million Americans in need of mental health care are hospitalized. These patients represent a most severely ill group. When hospitalized, most receive the traditional treatment program that includes chemotherapy and some psychotherapeutic procedure. It is in these hospital settings that the greatest experience using psychotropic medication accures. Polypharmacy in psychiatry is a phenomenon growing out of clinical practice that may have important implications and ramifications in treatment of those requiring mental health care. A questionnaire describing the clinical course of an acute paranoid schizophrenic was sent to psychiatrists in New York and California to evaluate the novelty of and the relationship of polypharmacy to chronicity. Data from 312 New York and 107 California respondents indicated a statistically similar preference for polypharmacy at first contact with the patient. As drug treatment became ineffective, respondents significantly increased their preference for drug combinations. On the patient's third hospital admission, more than half of the respondents preferred a combination of psychotropic drugs. Preference for polypharmacy is replaced by maxipharmacy as symptoms resist treatment.