Associated factors in internists’ decisions of provisional psychiatric disorder treatment: Thammasat University Hospital

Abstract

Introduction: The Thai Medical Council requires internists to have knowledge about psychiatric disorders and initial treatment. This research aims to determine the barriers to provisional treatment of mental disorders perceived by internists.
Methods: A cross-sectional descriptive study was investigated among 90 internists who worked at Thammasat University Hospital in the academic year of 2016. The self-rated questionnaires
which were created by the researchers comprised demographic data, clinical experiences and perceived barriers to provisional treatment of psychiatric patients.
Results: There were 56 internists from the total of 61 participating in this survey. The response rate was 91.8 %. The factors associated with the internist’s provisional mental disorder treatment
including the internist’s year-level in the internship program, the psychiatric grade point average, the number of psychiatric patients per week, the experience of psychiatric patients’ inappropriate manners, andthe psychiatric patients’ criticism or legal prosecution (p < 0.05). The predictive factors ofprovisional psychiatric treatment by immediately referring the psychiatric patients to the psychiatrists with no primary treatment were the first-year internists and the experiences of psychiatric patients’ criticism or legal prosecution. (OR=6.3, 95%C.I.; 1.6, 25.0 and OR=5.5, 95%C.I.; 1.1, 27.5 respectively).
Conclusion: Being the first-year internist and a patient’ complaints or legal prosecution experiences had association with the internists’ provisional psychiatric management. The hospital authority should develop the first-year internists’ competency in mental disorder practice and conduct the support strategy to help the internists for psychiatric disorder treatment.