Psychiatric Quarterly

, Volume 83, Issue 2, pp 221–239 | Cite as

Psychiatrist Characteristics Related to Patient Outcome in Japan

  • Takeru Abe
  • Megumi Moriya
  • Koji Ikeda
  • Kenji Kuroda
  • Akihito Hagihara
Original Paper


We evaluated psychiatric care in terms of the relationship between patient outcome (length of stay, Global Assessment of Functioning (GAF) at discharge, GAF difference, and GAF change per day) and psychiatrist characteristics (gender and years in psychiatric practice) in patients with schizophrenia, schizotypal, or delusional disorders (ICD-10 codes F20–F29) and in those with mood disorders (ICD-10 codes F30–F39). The sample consisted of inpatients discharged from an institute in Japan between April 2007 and March 2008. Multivariate analyses were performed to identify patient and psychiatrist characteristics related to outcome. We found that psychiatrist characteristics, such as gender and years in practice, were associated with GAF-related outcomes in patients in the F20–F29 and F30–F39 code groups (P < 0.05, P < 0.001, respectively). Patient characteristics and clinical factors such as GAF at admission, ward type, arrival by ambulance, admission type, seclusion, restraint, diagnosis, and patient age, were associated with outcome in both diagnostic groups. These findings show that gender and years in psychiatric practice had a significant effect on psychiatric patient outcome. Further studies in multiple institutes using a follow-up design are necessary to verify these findings.


Psychiatrist Global Assessment of Functioning Outcome 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Ng C, Setoya Y, Koyama A, Takeshima T: The ongoing development of community mental health services in Japan: Utilizing strengths and opportunities. Australasian Psychiatry 18:57–62, 2010PubMedCrossRefGoogle Scholar
  2. 2.
    Imai H, Hosomi J, Nakao H, Tsukino H, Katoh T, Itoh T, Yoshida T: Characteristics of psychiatric hospitals associated with length of stay in Japan. Health Policy 74:115–121, 2005PubMedCrossRefGoogle Scholar
  3. 3.
    Ministry of Health, Labour and Welfare: Kanja tyosa no gaikyo [Summary of patient survey], 2008. Accessed 10 Aug 2010 [in Japanese]
  4. 4.
    Oshima I, Nino Y, Inomata Y: Institutionalisation and schizophrenia in Japan: Social environments and negative symptoms. British Journal of Psychiatry 183:50–56, 2003PubMedCrossRefGoogle Scholar
  5. 5.
    Söderberg P, Tungström S, Armelius BA: Reliability of Global Assessment of Functioning ratings made by clinical psychiatric staff. Psychiatric Services 56(4):434–438, 2005PubMedCrossRefGoogle Scholar
  6. 6.
    Chung WJ, Cho WH, Yoon CW: The influence of institutional characteristics on length of stay for psychiatric patients: A national database study in South Korea. Social Science & Medicine 68:1137–1144, 2009CrossRefGoogle Scholar
  7. 7.
    Fujita T, Sato T: [Seishinbyoin deno chokitaizai ni kanrensuru youin] Factors associated with long length of stay in psychiatric institutes. [Kōsei no shihyō] Public Health and Welfare Index 52(1):12–19, 2004 [in Japanese]Google Scholar
  8. 8.
    Abe T, Ikeda K, Kuroda K, Hagihara A: Assessment of psychiatric outcomes in Japan based on diagnostic procedure combination information. Psychiatric Quarterly 82:163–175, 2011PubMedCrossRefGoogle Scholar
  9. 9.
    Choudhry NK, Fletcher RH, Soumerai SB: Systematic review: The relationship between clinical experience and quality of health care. Annals of Internal Medicine 142:260–273, 2005PubMedGoogle Scholar
  10. 10.
    Rosen MP, Davis RB, Lesky LG: Utilization of outpatient diagnostic imaging does the physician’s gender play a role? Journal of General Internal Medicine 12:407–411, 1997PubMedCrossRefGoogle Scholar
  11. 11.
    West JC, Leaf PJ, Zarin DA: Health plan characteristics and conformance with key practice guideline psychopharmacologic treatment recommendations for major depression. Mental Health Services Research 2(4):223–237, 2000CrossRefGoogle Scholar
  12. 12.
    Epstein SA, Gonzares JJ, Weinfurt K, Boekeloo B, Yuan N, Chase G: Are psychiatrists’ characteristics related to how they care for depression in the medically ill? Psychosomatics 42(6):482–489, 2001PubMedCrossRefGoogle Scholar
  13. 13.
    Lee HC, Lin HC: Are psychiatrist associated with postdischarge suicide of schizophrenia patients? Schizophrenia Bulletin 35(4):760–765, 2009PubMedCrossRefGoogle Scholar
  14. 14.
    Bowman D, Scogin F, Floyd M, Mckendree-Smith N: Psychotherapy length of stay and outcome: A meta-analysis of the effect of therapist sex. Psychotherapy 38(2):142–148, 2001CrossRefGoogle Scholar
  15. 15.
    Ministry of Health, Labour and Welfare: Central Social Insurance Medical Council, Medical Fee Committee, 2008. Accessed 1 May 2010 [in Japanese]
  16. 16.
    Ministry of Health, Labour and Welfare: Medical Fee & DPC Committee, 2008. Accessed 1 May 2010 [in Japanese]
  17. 17.
    Matsuda S: DPC no seishinka heno donyu [Introduction of DPC to the psychiatric department]. Seisin Shinkeigaku Zasshi 111(5):560–566, 2009 [In Japanese]Google Scholar
  18. 18.
    Hirakawa J: Kyuseiki seisinnka iryo no arikata to DPC seido [Acute stage psychiatric care and the DPC system]. Seisin Shinkeigaku Zasshi 111(5):585–587, 2009Google Scholar
  19. 19.
    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Text Revision, 4th edn. Washington, American Psychiatric Association, 1994Google Scholar
  20. 20.
    World Health Organization: International Classification of Diseases (ICD)-10 online, current version. Accessed 1 May 2010
  21. 21.
    Tabachnick BG, Fidell LS: Using Multivariate Statistics. Boston, Pearson Education, pp. 125–127, 2006Google Scholar
  22. 22.
    Cohen J, Cohen P, West SG, Aiken LS: Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Mahwah, Lawrence Erlbaum Associates, pp. 137–141, 2003.Google Scholar
  23. 23.
    Field A: Discovering Statistics Using SPSS, 4th edn. London, SAGE, 2009Google Scholar
  24. 24.
    Bjerrum L, Sǿggard J, Hallas J, Kragstrup J: Polypharmacy in general practice: Differences between practitioners. British Journal of General Practice 49:195–198, 1999PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Takeru Abe
    • 1
  • Megumi Moriya
    • 1
  • Koji Ikeda
    • 1
  • Kenji Kuroda
    • 2
  • Akihito Hagihara
    • 1
  1. 1.Department of Health Services, Management and PolicyKyushu University Graduate School of MedicineFukuokaJapan
  2. 2.Hannan HospitalSakai CityJapan

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