National Trends in Outpatient Psychotherapy
Objective:The authors investigated recent trends in the use of outpatient psychotherapy in the United States. Method:Service use data from two representative surveys of the U.S. general population, the 1998 (N=22,953) and 2007 (N=29,370) Medical Expenditure Panel Surveys, were analyzed, focusing on...
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| Veröffentlicht in: | The American journal of psychiatry 2010-12, Vol.167 (12), p.1456-1463 |
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| creator | Olfson, Mark Marcus, Steven C. |
| description | Objective:The authors investigated recent trends in the use of outpatient psychotherapy in the United States.
Method:Service use data from two representative surveys of the U.S. general population, the 1998 (N=22,953) and 2007 (N=29,370) Medical Expenditure Panel Surveys, were analyzed, focusing on individuals who made more than one outpatient psychotherapy visit during that calendar year. The authors computed rates of any psychotherapy use; percentages of persons treated for mental health conditions with only psychotherapy, only psychotropic medication, or their combination; the mean number of psychotherapy visits of persons receiving psychotherapy; and psychotherapy expenditures.
Results:The percentage of persons using outpatient psychotherapy was 3.37% in 1998 and 3.18% in 2007 (adjusted odds ratio=0.95, 95% CI=0.82−1.09). Among individuals receiving outpatient mental health care, use of only psychotherapy (15.9% and 10.5% in 1998 and 2007, respectively; adjusted odds ratio=0.66, 95% CI=0.48−0.90) as well as psychotherapy and psychotropic medication together (40.0% and 32.1%; adjusted odds ratio=0.73, 95% CI=0.59−0.90) declined while use of only psychotropic medication increased (44.1% and 57.4%; adjusted odds ratio=1.63, 95% CI=1.32−2.00). Declines occurred in annual psychotherapy visits per psychotherapy patient (mean values, 9.7 and 7.9; adjusted β=−1.53, p |
| doi_str_mv | 10.1176/appi.ajp.2010.10040570 |
| format | Article |
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Method:Service use data from two representative surveys of the U.S. general population, the 1998 (N=22,953) and 2007 (N=29,370) Medical Expenditure Panel Surveys, were analyzed, focusing on individuals who made more than one outpatient psychotherapy visit during that calendar year. The authors computed rates of any psychotherapy use; percentages of persons treated for mental health conditions with only psychotherapy, only psychotropic medication, or their combination; the mean number of psychotherapy visits of persons receiving psychotherapy; and psychotherapy expenditures.
Results:The percentage of persons using outpatient psychotherapy was 3.37% in 1998 and 3.18% in 2007 (adjusted odds ratio=0.95, 95% CI=0.82−1.09). Among individuals receiving outpatient mental health care, use of only psychotherapy (15.9% and 10.5% in 1998 and 2007, respectively; adjusted odds ratio=0.66, 95% CI=0.48−0.90) as well as psychotherapy and psychotropic medication together (40.0% and 32.1%; adjusted odds ratio=0.73, 95% CI=0.59−0.90) declined while use of only psychotropic medication increased (44.1% and 57.4%; adjusted odds ratio=1.63, 95% CI=1.32−2.00). Declines occurred in annual psychotherapy visits per psychotherapy patient (mean values, 9.7 and 7.9; adjusted β=−1.53, p<0.0001), mean expenditure per psychotherapy visit ($122.80 and $94.59; β=28.21, p<0.0001), and total national psychotherapy expenditures ($10.94 and $7.17 billion; z=2.61, p=0.009).
Conclusions:During the decade from 1998 to 2007, the percentage of the general population who used psychotherapy remained stable. Over the same period, however, psychotherapy assumed a less prominent role in outpatient mental health care as a large and increasing proportion of mental health outpatients received psychotropic medication without psychotherapy.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/appi.ajp.2010.10040570</identifier><identifier>PMID: 20686187</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Arlington, VA: American Psychiatric Publishing</publisher><subject>Ambulatory Care - economics ; Ambulatory Care - trends ; Attention deficit hyperactivity disorder ; Biological and medical sciences ; Drug Utilization - economics ; Drug Utilization - trends ; Health Care Surveys - methods ; Health Expenditures - trends ; Humans ; Medical sciences ; Mental disorders ; Mental health ; Mental Health Services - statistics & numerical data ; Older people ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychotherapy - economics ; Psychotherapy - trends ; Psychotropic drugs ; Studies ; United States</subject><ispartof>The American journal of psychiatry, 2010-12, Vol.167 (12), p.1456-1463</ispartof><rights>Copyright © American Psychiatric Association 2010</rights><rights>2015 INIST-CNRS</rights><rights>Copyright American Psychiatric Publishing, Inc. Dec 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a509t-fefae569675391f916838b77e3b07a9f2aef87d94fa45b4f51c3dcfd6c5dc2513</citedby><cites>FETCH-LOGICAL-a509t-fefae569675391f916838b77e3b07a9f2aef87d94fa45b4f51c3dcfd6c5dc2513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/appi.ajp.2010.10040570$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/appi.ajp.2010.10040570$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,780,784,2855,21626,21627,21628,27924,27925,77794,77799</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23620519$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20686187$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Olfson, Mark</creatorcontrib><creatorcontrib>Marcus, Steven C.</creatorcontrib><title>National Trends in Outpatient Psychotherapy</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>Objective:The authors investigated recent trends in the use of outpatient psychotherapy in the United States.
Method:Service use data from two representative surveys of the U.S. general population, the 1998 (N=22,953) and 2007 (N=29,370) Medical Expenditure Panel Surveys, were analyzed, focusing on individuals who made more than one outpatient psychotherapy visit during that calendar year. The authors computed rates of any psychotherapy use; percentages of persons treated for mental health conditions with only psychotherapy, only psychotropic medication, or their combination; the mean number of psychotherapy visits of persons receiving psychotherapy; and psychotherapy expenditures.
Results:The percentage of persons using outpatient psychotherapy was 3.37% in 1998 and 3.18% in 2007 (adjusted odds ratio=0.95, 95% CI=0.82−1.09). Among individuals receiving outpatient mental health care, use of only psychotherapy (15.9% and 10.5% in 1998 and 2007, respectively; adjusted odds ratio=0.66, 95% CI=0.48−0.90) as well as psychotherapy and psychotropic medication together (40.0% and 32.1%; adjusted odds ratio=0.73, 95% CI=0.59−0.90) declined while use of only psychotropic medication increased (44.1% and 57.4%; adjusted odds ratio=1.63, 95% CI=1.32−2.00). Declines occurred in annual psychotherapy visits per psychotherapy patient (mean values, 9.7 and 7.9; adjusted β=−1.53, p<0.0001), mean expenditure per psychotherapy visit ($122.80 and $94.59; β=28.21, p<0.0001), and total national psychotherapy expenditures ($10.94 and $7.17 billion; z=2.61, p=0.009).
Conclusions:During the decade from 1998 to 2007, the percentage of the general population who used psychotherapy remained stable. Over the same period, however, psychotherapy assumed a less prominent role in outpatient mental health care as a large and increasing proportion of mental health outpatients received psychotropic medication without psychotherapy.</description><subject>Ambulatory Care - economics</subject><subject>Ambulatory Care - trends</subject><subject>Attention deficit hyperactivity disorder</subject><subject>Biological and medical sciences</subject><subject>Drug Utilization - economics</subject><subject>Drug Utilization - trends</subject><subject>Health Care Surveys - methods</subject><subject>Health Expenditures - trends</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Mental Health Services - statistics & numerical data</subject><subject>Older people</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychotherapy - economics</subject><subject>Psychotherapy - trends</subject><subject>Psychotropic drugs</subject><subject>Studies</subject><subject>United States</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEtLAzEQgIMotlb_QimCeJCtk6RJNkcpvqBYDxW8hTSb0C3b3TXZPfTfmz4FL3oaZvjm9SHUxzDEWPB7Xdf5UC_rIYFNCWAETMAJ6mJGWSIISU9RFwBIIhn97KCLEJYxBSrIOeoQ4CnHqeiiuzfd5FWpi8HM2zILg7wcTNumjlVbNoP3sDaLqllYr-v1JTpzugj2ah976OPpcTZ-SSbT59fxwyTRDGSTOOu0ZVxywajETmKe0nQuhKVzEFo6oq1LRSZHTo_YfOQYNjQzLuOGZYYwTHvodje39tVXa0OjVnkwtih0aas2qFRKzAQn_yAxpynj8e0euv5FLqvWx7-3EEiAiPYQ30HGVyF461Tt85X2a4VBbbSrjXYVtauNdnXQHhv7--ntfGWzY9vBcwRu9oAORhfO69Lk4YejnADDMnJ0x20XHU_8Y_03tbSblA</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Olfson, Mark</creator><creator>Marcus, Steven C.</creator><general>American Psychiatric Publishing</general><general>American Psychiatric Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20101201</creationdate><title>National Trends in Outpatient Psychotherapy</title><author>Olfson, Mark ; Marcus, Steven C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a509t-fefae569675391f916838b77e3b07a9f2aef87d94fa45b4f51c3dcfd6c5dc2513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Ambulatory Care - economics</topic><topic>Ambulatory Care - trends</topic><topic>Attention deficit hyperactivity disorder</topic><topic>Biological and medical sciences</topic><topic>Drug Utilization - economics</topic><topic>Drug Utilization - trends</topic><topic>Health Care Surveys - methods</topic><topic>Health Expenditures - trends</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Mental disorders</topic><topic>Mental health</topic><topic>Mental Health Services - statistics & numerical data</topic><topic>Older people</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychotherapy - economics</topic><topic>Psychotherapy - trends</topic><topic>Psychotropic drugs</topic><topic>Studies</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olfson, Mark</creatorcontrib><creatorcontrib>Marcus, Steven C.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>The American journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olfson, Mark</au><au>Marcus, Steven C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>National Trends in Outpatient Psychotherapy</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>167</volume><issue>12</issue><spage>1456</spage><epage>1463</epage><pages>1456-1463</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>Objective:The authors investigated recent trends in the use of outpatient psychotherapy in the United States.
Method:Service use data from two representative surveys of the U.S. general population, the 1998 (N=22,953) and 2007 (N=29,370) Medical Expenditure Panel Surveys, were analyzed, focusing on individuals who made more than one outpatient psychotherapy visit during that calendar year. The authors computed rates of any psychotherapy use; percentages of persons treated for mental health conditions with only psychotherapy, only psychotropic medication, or their combination; the mean number of psychotherapy visits of persons receiving psychotherapy; and psychotherapy expenditures.
Results:The percentage of persons using outpatient psychotherapy was 3.37% in 1998 and 3.18% in 2007 (adjusted odds ratio=0.95, 95% CI=0.82−1.09). Among individuals receiving outpatient mental health care, use of only psychotherapy (15.9% and 10.5% in 1998 and 2007, respectively; adjusted odds ratio=0.66, 95% CI=0.48−0.90) as well as psychotherapy and psychotropic medication together (40.0% and 32.1%; adjusted odds ratio=0.73, 95% CI=0.59−0.90) declined while use of only psychotropic medication increased (44.1% and 57.4%; adjusted odds ratio=1.63, 95% CI=1.32−2.00). Declines occurred in annual psychotherapy visits per psychotherapy patient (mean values, 9.7 and 7.9; adjusted β=−1.53, p<0.0001), mean expenditure per psychotherapy visit ($122.80 and $94.59; β=28.21, p<0.0001), and total national psychotherapy expenditures ($10.94 and $7.17 billion; z=2.61, p=0.009).
Conclusions:During the decade from 1998 to 2007, the percentage of the general population who used psychotherapy remained stable. Over the same period, however, psychotherapy assumed a less prominent role in outpatient mental health care as a large and increasing proportion of mental health outpatients received psychotropic medication without psychotherapy.</abstract><cop>Arlington, VA</cop><pub>American Psychiatric Publishing</pub><pmid>20686187</pmid><doi>10.1176/appi.ajp.2010.10040570</doi><tpages>8</tpages></addata></record> |
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| subjects | Ambulatory Care - economics Ambulatory Care - trends Attention deficit hyperactivity disorder Biological and medical sciences Drug Utilization - economics Drug Utilization - trends Health Care Surveys - methods Health Expenditures - trends Humans Medical sciences Mental disorders Mental health Mental Health Services - statistics & numerical data Older people Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychotherapy - economics Psychotherapy - trends Psychotropic drugs Studies United States |
| title | National Trends in Outpatient Psychotherapy |
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