Anxiety Disorders: Common, Often Untreated

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Nearly one-fifth of patients in health clinics may have anxiety disorders, and many of them aren't getting help for their anxiety disorder, a new study suggests.

Anxiety disorders go beyond normal anxiety or fear. Here's how the National
Institute of Mental Health describes common types of anxiety disorders:

  • Generalized anxiety disorder. Chronic anxiety, even with little or no
  • Panic disorder. Sudden bouts of terror, often accompanied by a pounding
    heart, sweatiness, weakness, fainting, or dizziness.
  • Posttraumatic stress disorder (PTSD). An anxiety disorder that can develop after exposure to a terrifying event such as a violent personal assault, disaster, accident, or military combat.
  • Social anxiety disorder (social phobia). Overwhelming anxiety and excessive self-consciousness in everyday social situations.
  • Obsessive-compulsive disorder. Recurrent, unwanted thoughts (obsessions)
    and/or repetitive behaviors (compulsions).

    Anxiety has long been known to be a common mental health problem. The new
    study spotlights a brief survey that doctors could use to help screen patients for anxiety disorders.

    The study appears in the Annals of Internal Medicine. The researchers
    included Kurt Kroenke, M.D., of the Regenstrief Institute for Health Care in

    They studied 965 patients at family practice or internal medicine health clinics in 12 states. The patients were 18-87 years old (average age: 47); most were white women.

    Kroenke's team developed a seven-item survey to gauge patients' anxiety, nervousness, worrying, irritability, inability to relax, and fear during the previous two weeks. The survey is a lengthier version of another anxiety survey. The patients completed the seven-item survey before seeing their doctors. Later, they were interviewed via telephone by mental health professionals.

    The study shows that 188 patients — nearly 20 percent — had at least one anxiety disorder. That includes 83 patients who had posttraumatic stress disorder, 73 patients with generalized anxiety disorder, 66 patients with panic disorder, and 60 patients with social anxiety disorder. The researchers did not include obsessive-compulsive disorder in their study.

    Several patients had more than one type of anxiety disorder. Forty-two patients had two anxiety disorders, 14 had three disorders, and eight had four disorders. Among patients with at least one anxiety disorder, 41 percent said they weren't getting any medication, counseling, or psychotherapy.

    The anxious patients were more likely to be depressed and reported more disability days in the previous three months compared with those without anxiety disorders.

    The survey may help doctors identify patients with anxiety disorder, write Kroenke and colleagues.

    Identifying anxiety disorders is the first step toward getting help, note journal editorialists Wayne Katon, M.D., and Peter Roy-Byrne, M.D., who work in Seattle at the University of Washington's medical school.

    The study has some limits. For instance, patients who declined the follow-up interview weren't included in the results. They tended to be less anxious than those who agreed to the interview.

    The study was funded by the drug company Pfizer. In the journal, the researchers disclose consultancies, grants, or honoraria from the drug companies Pfizer, Eli Lilly, and Wyeth. The editorialists note consultancies, honoraria, and grants from the drug companies Alza, Cephalon, Eli Lilly, Forest Pharmaceuticals, GlaxoSmithKline, Jazz Pharmaceuticals, Novartis, Pfizer, Pharmacia, Roche, Solvay, Wyeth-Ayerst, and the Janssen Research Foundation.

    By Miranda Hitti
    Reviewed by Louise Chang, M.D.
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