Revisiting the canons of psychiatry: Teaching the fundamentals of CATIE, STAR*D, and STEP-BD to family medicine residents

摘要

Family medicine physicians are often the first providers to encounter and identify mental illness in their patients. Having a solid understanding of three landmark studies—Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), Sequenced Treatment Alternatives to Relieve Depression (STAR*D), and Systemic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)—can significantly improve a family medicine physician’s approach to mental illness and treatment choices, ultimately improving patient outcomes. Each of these studies has generated dozens of publications and consolidating the fundamentals of each one is essential for a resident to retain and implement findings in a real-world setting when treating patients with schizophrenia, depression, and bipolar disorder. When presented at the 38th Forum for Behavioral Science in Family Medicine in Chicago, IL, in September 2017, learners answered pre- and post-presentation questions about the treatment and guidelines pertaining to the three studies. Discussion leaders—physicians double-boarded in family medicine and psychiatry—presented key findings, clinical guidelines generated from each study, and updates since their respective publications. At the conclusion of the talk, participants received access to a slide deck and one-page summary for use in teaching at their home residency programs. Here, we present a framework for teaching family medicine residents three important canons of psychiatry with the goal of better management of three commonly encountered mental illnesses in the primary care setting.