Adjustment disorder with anxiety in old age: Comparing prevalence and clinical management in primary care and mental health care
| Autor: | Ashraf Saleh, P.H. Robert, C. Arbus, T. Hergueta, Vincent Camus, A. Duburcq, M.-E. Le Guern |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Mental Health Services medicine.medical_specialty Hamilton Anxiety Rating Scale medicine.drug_class Adjustment disorders Prevalence Primary care Anxiety Adjustment Disorders 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Practice Patterns Physicians' Psychiatry Aged Mini-international neuropsychiatric interview Psychiatric Status Rating Scales Benzodiazepine Primary Health Care business.industry Middle Aged medicine.disease 030227 psychiatry Psychiatry and Mental health Cross-Sectional Studies Anti-Anxiety Agents Mental health care Female medicine.symptom business |
| Zdroj: | European Psychiatry. 29:233-238 |
| ISSN: | 1778-3585 0924-9338 |
| DOI: | 10.1016/j.eurpsy.2013.04.002 |
| Popis: | Purpose:Adjustment disorder with anxiety (AjD-A) is a common cause of severe anxiety symptoms, but little is known about its prevalence in old age.Methods:This cross-sectional study examined the prevalence of AjD-A in outpatients over the age of 60 who consecutively consulted 34 general practitioners and 22 psychiatrists during a 2-week period. The diagnosis of AjD-A was obtained using the optional module for diagnostic of adjustment disorder of the Mini International Neuropsychiatric Interview (MINI). The study procedure also explored comorbid psychiatric conditions and documented recent past stressful life events, as well as social disability and current pharmacological and non-pharmacological management.Results:Overall, 3651 consecutive subjects were screened (2937 in primary care and 714 in mental health care). The prevalence rate of AjD-A was 3.7% (n = 136). Up to 39% (n = 53) of AjD-A subjects had a comorbid psychiatric condition, mostly of the anxious type. The most frequently stressful life event reported to be associated with the onset of AjD-A was personal illness or health problem (29%). More than 50% of the AjD-A patients were markedly to extremely disabled by their symptoms. Compared to patients who consulted psychiatrists, patients who were seen by primary care physicians were older, had obtained lower scores at the Hamilton Anxiety Rating Scale, benefited less frequently from non-pharmacological management and received benzodiazepines more frequently.Conclusions:AjD-A appears to be a significantly disabling cause of anxiety symptoms in community dwelling elderly persons, in particular those presenting personal health related problems. Improvement of early diagnosis and non-pharmacological management of AjD-A would contribute to limit risks of benzodiazepine overuse, particularly in primary care settings. |
| Databáze: | OpenAIRE |
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