TY - JOUR
KW - Anxiety Disorders/diagnosis/epidemiology/therapy
KW - Clinical Competence
KW - Comorbidity
KW - Depressive Disorder/diagnosis/epidemiology/therapy
KW - Diagnosis, Differential
KW - Emergency Medical Services/utilization
KW - Humans
KW - Patient Care Planning
KW - Patient Care Team/utilization
KW - Patient Participation
KW - Physicians, Family/standards
KW - Prevalence
KW - Primary Health Care/standards/statistics & numerical data/utilization
KW - Psychotherapy/methods
KW - Psychotropic Drugs/therapeutic use
KW - Somatoform Disorders/diagnosis/epidemiology/therapy
KW - Treatment Outcome
KW - United States/epidemiology
AU - P. P. Roy-Byrne
AU - A. Wagner
A1 - 
AB - 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.
BT - The Journal of clinical psychiatry
C5 - Medically Unexplained Symptoms
CY - United States
JF - The Journal of clinical psychiatry
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.
PP - United States
PY - 2004
SN - 0160-6689; 0160-6689
SP - 20
EP - 26
EP - 
T1 - Primary care perspectives on generalized anxiety disorder
T2 - The Journal of clinical psychiatry
TI - Primary care perspectives on generalized anxiety disorder
U1 - Medically Unexplained Symptoms
U2 - 15384933
VL - 65 Suppl 13
VO - 0160-6689; 0160-6689
Y1 - 2004
ER -