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The Use of Nonphysicians in a Health Maintenance Program for Affective Disorders
Edward M. Shelley; Ronald R. Fieve
Psychiatric Services 1974; doi:
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Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York

Department of Internal Medicine New York State Psychiatric Institute, New York, New York

1974 by the American Psychiatric Association

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This study focused on the effectiveness of nonphysicians in providing care for outpatients suffering from manic-depressive disease. All the patients were participating in a longitudinal study of the potential of lithium in preventing affective illness. The 20 patients studied had all been followed for the same 78-week period, during which they were seen and interviewed at least once a month by teams of psychiatric nurses and aides. The teams used a manic-depressive rating scale to detect symptoms that might need a physician's attention. Fourteen of the patients remained free of affective episodes and never required the services of a psychiatrist. The approach expanded the availability of psychiatric services without sacrificing effectiveness.

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