By Jonathan Rottenberg
April 21, 2010
A rich scientific study raises more questions than it answers.
This point is exemplified by new work conducted at Rhode Island Hospital and published in the Journal of Clinical Psychiatry.
The investigators followed 300 patients who were in ongoing outpatient treatment for depression over six weeks. The authors compared what the patient reported on a standardized scale of 31 different side effects (Toronto Side Effects Scale; TSES) with the information recorded by the treating psychiatrist on each patient’s chart. The main finding: A stunning disconnect between psychiatrists and their patients. The average number of side effects reported by the patients on the TSES was 20 times (!) higher than the number recorded by the psychiatrist. When the investigators concentrated on those side effects that were most troubling to the patient, patients still reported 2 to 3 times more side effects than were recorded by the treating psychiatrist.
The authors summarize their provocative findings in mild language, “The findings of the present study indicate that clinicians do not record in their progress notes most side effects reported on a side effects questionnaire by psychiatric outpatients receiving ongoing pharmacological treatment for depression.”
Whatever the explanation, psychiatrists appear to believe that patients are having fewer problems with medications than they truly are. It is hard to see how psychiatrists can act in the best interest of their patients if they do not know what their patients are experiencing!!!!