Tadmon D, Phil M, Olfson M, et al. - Patterns and trends of psychotherapy by US psychiatrists from 1996 to 2016 have been described.

• Psychiatrist visits from 21 waves of the US National Ambulatory Medical Care Survey between 1996 and 2016 (N = 29,673) were analyzed in this retrospective, nationally representative analysis.

• A significant decline occurred in the weighted percentage of visits involving psychotherapy from 44.4% in 1996–1997 to 21.6% in 2015–2016.

• Patients diagnosed with social phobia (29% to 8%), dysthymic disorder (65% to 30%), and personality disorders (68% to 17%) had these declines most marked.

• There remained stable psychotherapy provision (10%–12%) for patients diagnosed with schizophrenia.

• In the 2010–2016 period, psychotherapy was no longer provided by about half of psychiatrists (53%), creating new challenges to the integration of neurobiological and psychosocial elements of clinical care.

• There appeared a negative association of antidepressant, antipsychotic, and sedative-hypnotic prescriptions with psychotherapy provision.

• An increase in sociodemographic disparities occurred during the study period, with older, White patients residing in metropolitan areas in the Northeast or West increasingly becoming the most likely to receive psychotherapy.

• Self-pay was predictive of access to solo-practice psychiatrists, who saw fewer patients but more frequently, and more often provided psychotherapy.