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Psychiatrists and Primary Care Physicians Beliefs About Overtreatment of Depression and Anxiety

Lawrence, Ryan E. MD, MDiv*; Rasinski, Kenneth A. PhD; Yoon, John D. MD; Curlin, Farr A. MD§

Journal of Nervous & Mental Disease: February 2015 - Volume 203 - Issue 2 - p 120–125
doi: 10.1097/NMD.0000000000000247
Original Articles

Abstract: Critics say that physicians overdiagnose and overtreat depression and anxiety. We surveyed 1504 primary care physicians (PCPs) and 512 psychiatrists, measuring beliefs about overtreatment of depression and anxiety and predictions of whether persons would benefit from taking medication, investing in relationships, and investing in spiritual life. A total of 63% of PCPs and 64% of psychiatrists responded. Most agreed that physicians too often treat normal sadness as a medical illness (67% of PCPs and 62% of psychiatrists) and too often treat normal worry and stress as a medical illness (59% of PCPs, 55% of psychiatrists). Physicians who agreed were less likely to believe that depressed or anxious people would benefit “a lot” from taking an antidepressant (36% vs. 58% of PCPs) or antianxiety medication (25% vs. 42% of PCPs, 42% vs. 57% of psychiatrists). Most PCPs and psychiatrists believe that physicians too often treat normal sadness and worry as a medical illness.

*Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, NY; †Program on Medicine and Religion and ‡Department of Medicine and the MacLean Center for Clinical Medical Ethics, University of Chicago, Illinois; and §Trent Center for Bioethics, Humanities, and History of Medicine, and The Divinity School, Duke University, Durham, NC.

Send reprint requests to Ryan E. Lawrence, MD, MDiv, Department of Psychiatry, Columbia University Medical Center, New York, Presbyterian Hospital, 9 Garden North, 177 Fort Washington Avenue, New York, NY 10032. E-mail: rlawrence@uchicago.edu.

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