Psychopharmacotherapy of depressive patients before admission to a psychiatric hospital

Abstract

Objective: The aim of the study was to investigate the psychopharmacotherapy of inpatients with depressive disorders referred by psychiatrists in private practice (PP) and general practitioners (GP). Methods: Data of the German psychiatric basic documentation system (BADO) of all depressive inpatients (n=360) admitted to the Department of Psychiatry and Psychotherapy in 2003 were analysed. Results: 18.4% of the inpatients were referred by a PP, 22.4% by a GP. 77.1% of PP-patients and 58.8% of GP-patients were admitted due to a chronic course of illness. PP-patients had significantly more often a psychopharmalogical treatment before admission (89.7% vs. GP: 59.4%; p<0.001): PP prescribed significantly more often antidepressive drugs (87.9% vs. GP: 53.1%; p<0,001) with regard to tricyclic antidepressants (41.4% vs. GP: 29.7%), selective serotonin reuptake inhibitors (44.8% vs. GP: 29.7%) as well as other antidepressive drugs (17.2% vs. GP: 10.9%). 13.8% of PP-patients and 15.6% of GP-patients received tranquilizers, mostly benzodiazepines. Mood stabilizers were in use by 13.8% of PP-patients (GP: 7.8%). Conclusion: The study points to a diagnostic-therapeutical deficit of GPs concerning depressive disorders. Early recognition and improvement of treatment of depressive patients in primary care should be a main objective of psychiatric education for GPs.