ANXIETY RESEARCH

Anxiety disorders common, often untreated

Monday, March 5, 2007
NEW YORK (Reuters Health) - In a study of patients seen at primary care clinics, nearly 20 percent had at least one anxiety disorder and 41 percent of these patients were receiving no treatment.

Dr. Kurt Kroenke, from the Regenstrief Institute in Indianapolis, and colleagues assessed the prevalence and treatment of anxiety disorder by surveying and interviewing 965 patients randomly selected from 15 primary care clinics in the U.S.

Overall, 19.5 percent of patients had at least one anxiety disorder. The most common disorder was posttraumatic stress disorder, noted in 8.6 percent of patients, followed by generalized anxiety disorder in 7.6 percent, panic disorder in 6.8 percent, and social anxiety disorder in 6.2 percent. Diagnosis of an anxiety disorder was associated with worse functional status, more disability days, and more trips to the doctor, the researchers note in their report in the Annals of Internal Medicine. As noted, 41 percent of patients with an anxiety disorder were currently receiving no treatment.

Kroenke and colleagues developed a brief 7-item questionnaire, called the Generalized Anxiety Disorder (GAD)-7 scale, which they say doctors can use to easily spot patients with anxiety disorder. The GAD-7 was highly sensitive and specific in detecting all four anxiety disorders studied, the researchers note.

SOURCE: Annals of Internal Medicine, March 6, 2007.

Half of Adults With Anxiety Disorders Had Psychiatric Diagnoses in Youth

About half of adults with an anxiety disorder had symptoms of some type of psychiatric illness by age 15, a NIMH-funded study shows. Researchers also found that some of the specific illnesses detected in youth were clues as to what kinds of anxiety disorders — there are several — the youth would have as adults. The results underscore the importance of early diagnosis and prevention of anxiety disorders, and suggest that different anxiety disorders may have different roots.

Results of the study were published in the February issue of the American Journal of Psychiatry. Anxiety disorders are among the most common psychiatric illnesses, with 28.81 percent of American adults diagnosed with one or more at some point in life. They include social and other phobias, posttraumatic stress disorder (PTSD), generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder.

In this study, researchers examined the psychiatric histories, from ages 11 through 32, of 1,037 adults. Of the 232 adults with anxiety disorders, the most common childhood psychiatric illnesses — one-third of them — were anxiety disorders, followed by depression.
The researchers also found links between some disorders diagnosed in adulthood and those diagnosed during youth. Adults with PTSD had histories of extreme defiance and conduct disorders in childhood. Adults with obsessive-compulsive disorders tended to have had delusional beliefs and hallucinations as children. Phobias in adulthood tended to be linked to specific phobias that occurred during childhood. Considering psychiatric history when diagnosing adult anxiety disorders could benefit diagnosis, prevention, and treatment, the study's authors write.

The research was a collaboration among NIMH-funded researchers Alice M. Gregory, Avshalom Caspi, Terrie E. Moffitt, and Karestan Koenen, of Goldsmith's College and King's College London, Duke University, and Harvard University, who were joined by Thalia C. Eley and Richie Poulton, of King's College London and University of Otago (New Zealand).

1 Kessler RC, Berglund PA, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):593-602.

SOURCE: Gregory AM, Caspi A, Moffitt, TE, Koenen K, Eley TC, Poulton R. Juvenile Mental Health Histories of Adults With Anxiety Disorders. American Journal of Psychiatry, 164:1-8. February 2007.

RELATED LINKS:
http://www.socialphobia.org.nz/

http://www.agoraphobia.org.nz/

http://www.phobic.org.nz/

http://www.ocd.org.nz/