Psychiatric Practice: A March from the Brainless to the Mindless?

Psychotherapy has long been considered an essential component of the psychiatrist’s work and is one of the cornerstones of the biopsychosocial model from the 1980s. Many experts still adhere to this model, which emphasizes that psychiatry was the specialty that could best integrate all relevant dimensions of illness. This report of data from a national survey of representative outpatient medical practices from 1996 to 2005 suggests that the psychosocial and biological components of psychiatry are increasingly split.

The investigators surveyed 14,108 visits to psychiatrists involving a psychiatric diagnosis. The percentage of visits with at least 30 minutes of psychotherapy decreased significantly over 10 years from 44% to 29%. For patients w…