The higher one-day prevalence of psychotropic drug prescription for men than women in this sample is probably a bias created by inclusion of OBGYN. It could also be a reflection of the in-patient population. Out-patient studies have found higher prevalence in women than in men. However 52.5% of all patients to whom psychotropic drugs were prescribed were women, a reflection of the overrepresentation of women (57.4% ver sus 42.6% men) in the sample.
The two general hospitals with psychiatry wards prescribed relatively more psychotropic drugs but less BZD Plus. They made a wider selection from the five classes of psychotropic studied and used fewer PRN dose scheduling than the hospital without a psychiatry ward. These findings indicate that education of practitioners may be useful or the availability of psychiatry units in general hospitals may be required. On the other hand, re ltricted use of psycholropic medications in the hospital with no psychiatry unit may reflect nonpatronage because patients with psychiatric problems in that hospital went to a hospital with a psychiatric unit.
Four of the five specialties studied, excluding PSYCH, were responsible for 56.3% of total prescriptions for psychotropic drugs. Thus, psychotropic drugs were used with great frequency by nonpsychiatrists. It is necessary that physicians have the knowledge to select the appropriate psychotropic medications and prescribe them in a way that is clinically effective and helpful to the patient, and which exposes the patient to the least untoward consequence. A viable approach is for p sy chiatry to intensify its role of consultation-liaison. Educating nonpsychiatric physicians in the judicious use ofpsy-chotropic medications may well come from liaison activities, continuing medical education and enhanced training in the respective training programs. The general hospital setting provides the opportunity for psychiatrists to work with patients on nonpsychiatric wards, and simultaneously teach other physicians reasonable criteria for referral to psychiatry and how best to use psychotropic medications.