Researchers at Johns Hopkins Bloomberg School of Public Health in Baltimore found that psychotherapy practice has almost halved in recent years, many psychiatrists prescribing their patients drugs instead of listening to their problems.

Psychotherapy is often recommended for people suffering from major depression, post-traumatic stress disorder, bipolar disorder and other psychiatric conditions. Sometimes it is accompanied by medication as well. The procedure include a range of techniques based on experimental relationship building, dialogue, communication and behavior change designed to improve the mental health of a patient or to improve group relationship.

There seems to be a couple of reasons behind this finding. More exactly, psychiatrists nowadays get reimbursed by insurance companies at a lower rate for a 45-minute psychotherapy visit than for three 15-minute medication visits, lead author Dr. Ramin Mojtabai of Johns Hopkins Bloomberg School of Public Health said.

Another possible reason could be a change in patients’ attitude. To be more specific, most patients consider taking a pill easier and more comfortable than psychotherapy, which involves more time or the regular participation of family members, said Dr. Mark Olfson of Columbia University Medical Center, another author of the study.

The researchers used data from the National Ambulatory Medical Care Survey, an anonymous survey of office-based physicians. The survey tracks characteristics of patients and physicians, and records the diagnosis and treatment during a typical week. The researchers analyzed data on 14,108 psychiatric office visits during a 10-year period.

They found that the percentage of patients’ visits to psychiatrists for psychotherapy or talk therapy fell from an average of 44 percent in 1996-1997 to an average of 29 percent in 2004-2005.

The couch, or more generally, long-term psychoanalytic psychotherapy, was for so long a hallmark of the practice of psychiatry. It no longer is,” Dr. Mojtabai said.

Moreover, the study found that patients willing to pay out of pockets were more likely to receive psychotherapy.

The change in treating patients with psychiatric conditions may be seen as something normal, as most of the today’s procedures used in other fields of medicine evolve to easier and more comfortable ones for both patients and doctors.

“Years ago, if someone had a herniated disk, they had a very complicated surgical procedure and were in traction for weeks. Fields change. What we don’t want to do is decide treatment based on reimbursement,” Dr. Alan F. Schatzberg, chairman of the department of psychiatry at Stanford University School of Medicine and president-elect of the American Psychiatric Association, said.

On the other hand, Dr. Eric Plakun, who leads an American Psychiatric Association committee, said he’s worried about “our patients” who “need the best help we can give them.” That means these patients should be provided a range of services, including psychotherapy and not just medication.

The findings were published in the August 4 issue of the Archives of General Psychiatry.