Treatment of Depressive Disorders in Split Versus Integrated Therapy and Comparisons of Prescriptive Practices of Psychiatrists and Advanced Practice Registered Nurses

This study examined the differences in adherence to medication for the treatment of depressive mood disorders whether the patient was involved in split or integrated therapy and if the patient was being treated by a psychiatrist or an advanced practice registered nurse (APRNs) in psychiatry with prescriptive authority. The sample consisted of 122 adults ages 20-60 who carried a diagnosis of major depression, dysthymia, or bipolar II disorder, voluntarily treated in the private sector. Chi-square was the measure used to assess differences in adherence. Adherence was determined by documentation from chart reviews, retrospectively, of the prescriptions for psychotropic medication for a period of up to nine months for each patient included in the research. Six psychiatrists and six APRNs volunteered to collect data from their private practices. Findings demonstrated no statistically significant differences in patient's adherence to medication if they were in split or integrated treatment or if either psychiatrists or an APRN treated them. Psychiatrists used more of secondary class of antidepressants and more antianxiety agents than did the APRNs. The nurses spent more time with patients, using more integrated therapy, than did the psychiatrists.