title: Treatment of Depression in Voluntary Versus Mandated Physicians.
abstract: Few if any publications discuss the effectiveness of voluntary versus mandated treatment for impaired physicians. This retrospective case-control study compared the recovery rates of physicians whose treatment was mandated or coerced by either licensure boards or employers (mandated physicians) with the rates for physicians admitted voluntarily (voluntary physicians) to the Menninger Clinic's Professionals in Crisis program from 2009 through 2012. Beck Depression Inventory (BDI)-II scores served as the primary outcome measure. At the time of admission, voluntary physicians were more depressed, but the improvement rates in the voluntary and mandated groups did not differ significantly. In addition, the two groups differed neither in rates of return to the healthy range of BDI-II scores, nor in whether BDI-II scores had decreased by at least two standard deviations by the time of discharge. These findings suggest that state physician health programs can continue to mandate physicians into treatment despite concerns that mandatory treatment may be less efficacious than voluntary treatment.
authors.affiliation: Dr. Johnson is a forensic psychiatry fellow at Massachusetts General Hospital/Harvard Medical School in Boston, MA. Dr. Sikes is the Medical Director, Cypress Creek Hospital, Houston, TX. Dr. Allen is Professor of Psychiatry and Helen Malsin Palley Chair in Mental Health Research, Dr. Fowler is Associate Professor, and Dr. Oldham is Professor and Executive Vice Chair for Clinical Affairs and Development, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX. Dr. Fowler is also Associate Director of Clinical Research, and Dr. Oldham is also Senior Vice President and Chief of Staff, The Menninger Clinic, Houston, TX. A preliminary poster of this material was presented at the 44th annual meeting of the American Academy of Psychiatry and the Law, October 24-27, 2013, San Diego, CA. RSJohnson@mgh.harvard.edu.
authors.forename: R Scott
authors.initials: RS
authors.lastname: Johnson
authors.affiliation: Dr. Johnson is a forensic psychiatry fellow at Massachusetts General Hospital/Harvard Medical School in Boston, MA. Dr. Sikes is the Medical Director, Cypress Creek Hospital, Houston, TX. Dr. Allen is Professor of Psychiatry and Helen Malsin Palley Chair in Mental Health Research, Dr. Fowler is Associate Professor, and Dr. Oldham is Professor and Executive Vice Chair for Clinical Affairs and Development, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX. Dr. Fowler is also Associate Director of Clinical Research, and Dr. Oldham is also Senior Vice President and Chief of Staff, The Menninger Clinic, Houston, TX. A preliminary poster of this material was presented at the 44th annual meeting of the American Academy of Psychiatry and the Law, October 24-27, 2013, San Diego, CA.
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Fowler
authors.affiliation: Dr. Johnson is a forensic psychiatry fellow at Massachusetts General Hospital/Harvard Medical School in Boston, MA. Dr. Sikes is the Medical Director, Cypress Creek Hospital, Houston, TX. Dr. Allen is Professor of Psychiatry and Helen Malsin Palley Chair in Mental Health Research, Dr. Fowler is Associate Professor, and Dr. Oldham is Professor and Executive Vice Chair for Clinical Affairs and Development, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX. Dr. Fowler is also Associate Director of Clinical Research, and Dr. Oldham is also Senior Vice President and Chief of Staff, The Menninger Clinic, Houston, TX. A preliminary poster of this material was presented at the 44th annual meeting of the American Academy of Psychiatry and the Law, October 24-27, 2013, San Diego, CA.
authors.forename: Kristi A
authors.initials: KA
authors.lastname: Sikes
authors.affiliation: Dr. Johnson is a forensic psychiatry fellow at Massachusetts General Hospital/Harvard Medical School in Boston, MA. Dr. Sikes is the Medical Director, Cypress Creek Hospital, Houston, TX. Dr. Allen is Professor of Psychiatry and Helen Malsin Palley Chair in Mental Health Research, Dr. Fowler is Associate Professor, and Dr. Oldham is Professor and Executive Vice Chair for Clinical Affairs and Development, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX. Dr. Fowler is also Associate Director of Clinical Research, and Dr. Oldham is also Senior Vice President and Chief of Staff, The Menninger Clinic, Houston, TX. A preliminary poster of this material was presented at the 44th annual meeting of the American Academy of Psychiatry and the Law, October 24-27, 2013, San Diego, CA.
authors.forename: Jon G
authors.initials: JG
authors.lastname: Allen
authors.affiliation: Dr. Johnson is a forensic psychiatry fellow at Massachusetts General Hospital/Harvard Medical School in Boston, MA. Dr. Sikes is the Medical Director, Cypress Creek Hospital, Houston, TX. Dr. Allen is Professor of Psychiatry and Helen Malsin Palley Chair in Mental Health Research, Dr. Fowler is Associate Professor, and Dr. Oldham is Professor and Executive Vice Chair for Clinical Affairs and Development, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX. Dr. Fowler is also Associate Director of Clinical Research, and Dr. Oldham is also Senior Vice President and Chief of Staff, The Menninger Clinic, Houston, TX. A preliminary poster of this material was presented at the 44th annual meeting of the American Academy of Psychiatry and the Law, October 24-27, 2013, San Diego, CA.
authors.forename: John M
authors.initials: JM
authors.lastname: Oldham
mesh_terms: D000328:Adult; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D037141:Mandatory Programs; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D026684:Personal Autonomy; D010815:Physician Impairment / Q000523:psychology*; D012189:Retrospective Studies; D014481:United States