Generalized anxiety disorder in primary care: mental health services use and treatment adequacy.

Autor: Roberge P; Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada. pasquale.roberge@usherbrooke.ca., Normand-Lauzière F; Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada. Francois.Normand.Lauziere@USherbrooke.ca., Raymond I; Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada. Isabelle.Raymond2@USherbrooke.ca., Luc M; Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada. mireille.luc@USherbrooke.ca., Tanguay-Bernard MM; Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada. Marie-Michele.Tanguay.Bernard@USherbrooke.ca., Duhoux A; Division of Neurology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001,12th Avenue North, Sherbrooke, QC, J1H 5 N4, Canada. arnaud.duhoux@umontreal.ca., Bocti C; Faculty of Nursing, Université de Montréal, Pavillon Marguerite-d'Youville, C.P. 6128 succ. Centre-ville, Montreal, QC, H3C 3 J7, Canada. Christian.Bocti@USherbrooke.ca., Fournier L; CRCHUM (Centre de recherche du Centre Hospitalier de l'Université de Montréal), Université de Montréal, Pavillon Édouard-Asselin, 264, boul. René-Lévesque Est, Montréal, QC, H2X 1P1, Canada. louise.fournier@umontreal.ca.
Jazyk: angličtina
Zdroj: BMC family practice [BMC Fam Pract] 2015 Oct 22; Vol. 16, pp. 146. Date of Electronic Publication: 2015 Oct 22.
DOI: 10.1186/s12875-015-0358-y
Abstrakt: Purpose: Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisation in a large sample of primary care patients; 2) explore detection of GAD and minimal standards for pharmacological and psychological treatment adequacy based on recommendation from clinical practice guidelines; 3) examine correlates of treatment adequacy, i.e. predisposing, enabling and needs factors according to the Behavioural Model of Health Care Use.
Methods: A sample of 373 adults meeting DSM-IV criteria for Generalized Anxiety Disorder in the past 12 months took part in this study. Data were drawn from the "Dialogue" project, a large primary care study conducted in 67 primary care clinics in Quebec, Canada. Following a mental health screening in medical clinics (n = 14833), patients at risk of anxiety or depression completed the Composite International Diagnostic Interview-Simplified (CIDIS). Multilevel logistic regression models were developed to examine correlates of treatment adequacy for pharmacological and psychological treatments.
Results: Results indicate that 52.5 % of participants were recognized as having GAD by a healthcare professional in the past 12 months, and 36.2 % of the sample received a pharmacological (24.4 %) and/or psychological treatment (19.2 %) meeting indicators based on clinical practice guidelines recommendations. The detection of GAD by a health professional and the presence of comorbid depression were associated with overall treatment adequacy.
Conclusions: This study suggests that further efforts towards GAD detection could lead to an increase in the delivery of evidence-based treatments. Key targets for improvement in treatment adequacy include regular follow up of patients with a GAD medication and access to psychotherapy from the primary care setting.
Databáze: MEDLINE
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