Postgraduate Psychiatry Training and Associated Greater Self-Rated Competence in Primary Care Physicians in Internal Medicine in Managing Mental Health Disorders in Japan

Objective: Despite the key role primary care physicians play in suicide prevention in Japan, successfully managing psychiatric disorders associated with suicide remains a challenge for healthcare practitioners. Postgraduate psychiatry training may be one way to improve the self-rated competence of primary care physicians and their ability to successfully manage these disorders. Previous studies have reported associations between mental health training and greater levels of physician confidence and skill; however, these associations have not been made in reference to specific mental disorders. Our study examined and provided quantitative, disorder-specific associations between postgraduate psychiatry training and confidence levels of primary care internal medicine physicians in managing different mental health disorders. The associations between postgraduate training and the capability of physicians to manage patients with mental health disorders were also evaluated. Design: Cross-sectional study Methods: Questionnaires were sent to 4,030 private clinics in Japan. After excluding responses from those working in non-private clinics and those without an internal medicine specialty, 544 responses were included in the analysis. Outcome data were measured by respondent self-report. Adjusted odds ratios of confidence and skillfulness in the management of various psychiatric disorders were calculated. Results: Experience of postgraduate psychiatry training was significantly associated with greater physician confidence levels in identifying, treating, and following-up of many psychiatric disorders (including schizophrenia and bipolar disorder). Training was also significantly associated with greater self-evaluated competency in providing patient education, psychological therapy, and specialist referrals. Conclusions: Postgraduate psychiatric training may be important in developing primary care physician self-rated competence in managing psychiatric disorders.