P. Fele, G. Ravera, R. Rossi - Vol. 6, Marzo 2000, num.1
Testo Immagini Bibliografia Summary Riassunto Indice
Psicoterapia vs farmaci: l’opinione
degli Psicoterapeuti
Psychotherapy versus drugs: the opinion of psychotherapy
Background
Despite reports that combined psychotherapy and drug treatment are more effective than either strategy alone, psychotherapists in their clinical practice tend to adopt either one or the other and not to trust integrated approaches. The objective of this study was to investigate therapeutic tendencies of physicians who practice psychotherapy.
Aim and Method
To this aim, we administered a questionnaire investigating the opinions on treatment of three clinical case vignettes describing patients affected by both DSM-IV axis I and II disorders to 226 physicians and psychotherapists licensed in the region Liguria, Italy.
Results
The filled-out form of the questionnaire was returned by 80 physicians, 67.5% of whom are psychodynamically oriented. Of them, 75% believe that drug prescription influences the psychotherapeutic relationship; of these, 58% believes that this influence is negative, while the remaining 42% believes it is positive. When the need for drug prescription is established, 52% of psychiatrists are likely to prescribe themselves, whereas 48% would never prescribe drugs to their patients on psychotherapy. Combined treatment up to 50% of cases is adopted by 89% of the doctors’ sample, whereas only 11% would adopt it in more than 50% of their patients. Drug treatment is not accepted by 25% of psychiatrists/psychotherapists in the case vignette of a patient affected by panic disorder, by 33% in the case affected by major depressive episode and by 70% in the case affected by somatoform disorder.
Conclusions
Mainly psychodynamically oriented psychiatrists who are practicing psychotherapy in Liguria, Italy, fear that the adoption of drug treatment in the context of an ongoing psychotherapeutic relationship could be detrimental to the latter; the magnitude of the fear depends on the type of DSM-IV Axis I disorder.