Burden for Anxiety Disorders Screening Falls on Primary Care Physicians
A post from our director, Dr. Rolf Gainer:
Individuals with anxiety disorders are high consumers of medical care
and often their point of contact and treatment is their primary care
physician. Anxiety disorders are the most frequent disorders
experienced by Americans and often accompanied by depression. Primary
Care physicians routinely see individuals reporting rapid heart rate,
unexplained chest pain, nervousness and other physical symptoms in
addition to reports of restricted social activity and functional
problems related to the physical health complaints.
In a study by Kurt Kroenke and others (Annals of Internal Medicine,
2007, 146: 317-325) 19.5% of patients seen by Primary Care Physicians
manifested anxiety disorders (Generalized Anxiety Disorder; Panic
Disorder; Social Anxiety Disorder and Post Traumatic Stress Disorder)
accompanied by high levels of co-morbid depression, somatic symptoms
and functional impairments. 40% of the individuals reported that they
were not receiving mental health treatment.
While depression screening tools are readily available and used by
Primary Care Physicians, the availability and use of anxiety screening
tools lags behind the patient care need and may serve to hamper
physicians in the assessment of individuals with anxiety problems.
Kroenke suggests the use of two screening questionnaires, the GAD-2
and the longer GAD-7. Through screening and identification,
individuals with anxiety disorders can be directed towards proper
treatment, including medication and cognitive behavioral therapy.
It is important that individuals presenting with a set physical
symptoms associated with anxiety be given appropriate screenings by
their primary care physicians and allied health professionals to
consider the potential for these physical symptoms to be signs of
anxiety disorders or other psychiatric problems. Helping individuals
with anxiety disorders to find and access appropriate treatment can
make a significant difference for the individual and prevent them from
becoming immobilized by their physical and psychological symptoms.