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Clinician treatment choices for post-traumatic stress disorder: ambassadors survey of psychiatrists in 39 European countries
- Martina Rojnic Kuzman, Frank Padberg, Benedikt L. Amann, Meryam Schouler-Ocak, Zarko Bajic, Tarja Melartin, Adrian James, Julian Beezhold, Jordi Artigue Gómez, Celso Arango, Tihana Jendricko, Jamila Ismayilov, William Flannery, Egor Chumakov, Koray Başar, Simavi Vahip, Dominika Dudek, Jerzy Samochowiec, Goran Mihajlovic, Fulvia Rota, Gabriela Stoppe, Geert Dom, Kirsten Catthoor, Eka Chkonia, Maria João Heitor Dos Santos, Diogo Telles, Peter Falkai, Philippe Courtet, Michal Patarák, Lubomira Izakova, Oleg Skugarevski, Stojan Barjaktarov, Dragan Babic, Goran Racetovic, Andrea Fiorillo, Bernardo Carpiniello, Maris Taube, Yuval Melamed, Jana Chihai, Doina Constanta Maria Cozman, Pavel Mohr, György Szekeres, Mirjana Delic, Ramunė Mazaliauskienė, Aleksandar Tomcuk, Nataliya Maruta, Philip Gorwood
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- Journal:
- European Psychiatry / Volume 67 / Issue 1 / 2024
- Published online by Cambridge University Press:
- 07 March 2024, e24
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Background
Considering the recently growing number of potentially traumatic events in Europe, the European Psychiatric Association undertook a study to investigate clinicians’ treatment choices for post-traumatic stress disorder (PTSD).
MethodsThe case-based analysis included 611 participants, who correctly classified the vignette as a case of PTSD, from Central/ Eastern Europe (CEE) (n = 279), Southern Europe (SE) (n = 92), Northern Europe (NE) (n = 92), and Western Europe (WE) (N = 148).
ResultsAbout 82% woulduse antidepressants (sertraline being the most preferred one). Benzodiazepines and antipsychotics were significantly more frequently recommended by participants from CEE (33 and 4%, respectively), compared to participants from NE (11 and 0%) and SE (9% and 3%). About 52% of clinicians recommended trauma-focused cognitive behavior therapy and 35% psychoeducation, irrespective of their origin. In the latent class analysis, we identified four distinct “profiles” of clinicians. In Class 1 (N = 367), psychiatrists would less often recommend any antidepressants. In Class 2 (N = 51), clinicians would recommend trazodone and prolonged exposure therapy. In Class 3 (N = 65), they propose mirtazapine and eye movement desensitization reprocessing therapy. In Class 4 (N = 128), clinicians propose different types of medications and cognitive processing therapy. About 50.1% of participants in each region stated they do not adhere to recognized treatment guidelines.
ConclusionsClinicians’ decisions for PTSD are broadly similar among European psychiatrists, but regional differences suggest the need for more dialogue and education to harmonize practice across Europe and promote the use of guidelines.
Clinical decision-making style preferences of European psychiatrists: Results from the Ambassadors survey in 38 countries
- Martina Rojnic Kuzman, Mike Slade, Bernd Puschner, Elisabetta Scanferla, Zarko Bajic, Philippe Courtet, Jerzy Samochowiec, Celso Arango, Simavi Vahip, Maris Taube, Peter Falkai, Geert Dom, Lubomira Izakova, Bernardo Carpiniello, Marcella Bellani, Andrea Fiorillo, Oleg Skugarevsky, Alma Mihaljevic-Peles, Diogo Telles-Correia, Filipa Novais, Pavel Mohr, Johannes Wancata, Martin Hultén, Eka Chkonia, Judit Balazs, Julian Beezhold, Lars Lien, Goran Mihajlovic, Mirjana Delic, Gabriela Stoppe, Goran Racetovic, Dragan Babic, Ramune Mazaliauskiene, Doina Cozman, Simon Hjerrild, Jana Chihai, William Flannery, Tarja Melartin, Nataliya Maruta, Armen Soghoyan, Philip Gorwood
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- Journal:
- European Psychiatry / Volume 65 / Issue 1 / 2022
- Published online by Cambridge University Press:
- 21 October 2022, e75
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Background
While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe.
MethodsWe conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style – Staff questionnaire and a set of questions regarding clinicians’ expertise, training, and practice.
ResultsSDM was the preferred decision-making style across all European regions ([central and eastern Europe, CEE], northern and western Europe [NWE], and southern Europe [SE]), with an average of 73% of clinical decisions being rated as SDM. However, we found significant differences in non-SDM decision-making styles: participants working in NWE countries more often prefer shared and active decision-making styles rather than passive styles when compared to other European regions, especially to the CEE. Additionally, psychiatry specialist trainees (compared to psychiatrists), those working mainly with outpatients (compared to those working mainly with inpatients) and those working in community mental health services/public services (compared to mixed and private settings) have a significantly lower preference for passive decision-making style.
ConclusionsThe preferences for SDM styles among European psychiatrists are generally similar. However, the identified differences in the preferences for non-SDM styles across the regions call for more dialogue and educational efforts to harmonize practice across Europe.