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Primary care perspectives on generalized anxiety disorder.
J Clin Psychiatry. 2004; 65 Suppl 13:20-6.JC

Abstract

Recently, there has been increased interest in the impact and treatment of anxiety disorders. However, one type of anxiety disorder, generalized anxiety disorder (GAD), has received less attention than other disorders, such as panic disorder, despite the prevalence and amenability of this disorder to treatment in the primary care setting. Rates of GAD have been found to be between 2.8% and 8.5%, with a median prevalence of 5.8%-at least twice the rate reported in the National Comorbidity Survey. Up to one third of patients presenting to primary care clinics with somatic complaints had a mood or anxiety disorder. Generalized anxiety disorder is linked to the overuse of medical services: emergency department visits, hospitalizations, diagnostic and laboratory tests, pharmacy costs, and so on. Recognition of anxiety and depression in primary care is poor, with only 23% of pure anxiety cases being recognized compared with 56% of depression cases. The various stakeholders (patients, family members, employers, and insurers) in a patient's outcome often complicate treatment of anxiety. Barriers to effective treatment include time constraints, acute disease orientation of most care systems, lack of planned follow-up and monitoring, and relative unavailability of specialist access. The collaborative care approach is designed to overcome these barriers. With this approach, the patient is provided with additional educational materials, physicians are supported by physician extenders (nurses, social workers, or expert consultants) who provide case-based feedback, follow-up, extra visits, and telephone calls to patients. Providing efficacious treatment to primary care for GAD will require improving knowledge of providers and increasing patient engagement.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Harborview Medical Center, Seattle, WA 98104, USA. roybyrne@u.washington.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

15384933

Citation

Roy-Byrne, Peter P., and Amy Wagner. "Primary Care Perspectives On Generalized Anxiety Disorder." The Journal of Clinical Psychiatry, vol. 65 Suppl 13, 2004, pp. 20-6.
Roy-Byrne PP, Wagner A. Primary care perspectives on generalized anxiety disorder. J Clin Psychiatry. 2004;65 Suppl 13:20-6.
Roy-Byrne, P. P., & Wagner, A. (2004). Primary care perspectives on generalized anxiety disorder. The Journal of Clinical Psychiatry, 65 Suppl 13, 20-6.
Roy-Byrne PP, Wagner A. Primary Care Perspectives On Generalized Anxiety Disorder. J Clin Psychiatry. 2004;65 Suppl 13:20-6. PubMed PMID: 15384933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary care perspectives on generalized anxiety disorder. AU - Roy-Byrne,Peter P, AU - Wagner,Amy, PY - 2004/9/24/pubmed PY - 2004/10/23/medline PY - 2004/9/24/entrez SP - 20 EP - 6 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 65 Suppl 13 N2 - Recently, there has been increased interest in the impact and treatment of anxiety disorders. However, one type of anxiety disorder, generalized anxiety disorder (GAD), has received less attention than other disorders, such as panic disorder, despite the prevalence and amenability of this disorder to treatment in the primary care setting. Rates of GAD have been found to be between 2.8% and 8.5%, with a median prevalence of 5.8%-at least twice the rate reported in the National Comorbidity Survey. Up to one third of patients presenting to primary care clinics with somatic complaints had a mood or anxiety disorder. Generalized anxiety disorder is linked to the overuse of medical services: emergency department visits, hospitalizations, diagnostic and laboratory tests, pharmacy costs, and so on. Recognition of anxiety and depression in primary care is poor, with only 23% of pure anxiety cases being recognized compared with 56% of depression cases. The various stakeholders (patients, family members, employers, and insurers) in a patient's outcome often complicate treatment of anxiety. Barriers to effective treatment include time constraints, acute disease orientation of most care systems, lack of planned follow-up and monitoring, and relative unavailability of specialist access. The collaborative care approach is designed to overcome these barriers. With this approach, the patient is provided with additional educational materials, physicians are supported by physician extenders (nurses, social workers, or expert consultants) who provide case-based feedback, follow-up, extra visits, and telephone calls to patients. Providing efficacious treatment to primary care for GAD will require improving knowledge of providers and increasing patient engagement. SN - 0160-6689 UR - https://www.unboundmedicine.com/medline/citation/15384933/Primary_care_perspectives_on_generalized_anxiety_disorder_ L2 - http://www.psychiatrist.com/jcp/article/pages/2004/v65s13/v65s1304.aspx DB - PRIME DP - Unbound Medicine ER -