Anxiety Disorders Common, Untreated

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.

Screening for Anxiety Disorders

The study appears in the Annals of Internal Medicine. The researchers
included Kurt Kroenke, MD, 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

The patients completed the seven-item survey before seeing their doctors.
Later, they were interviewed via telephone by mental health professionals.

Anxiety Disorders Were Common

The study shows that 188 patients -- nearly 20% -- had at least one anxiety

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

Among patients with at least one anxiety disorder, 41% 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, MD, and Peter Roy-Byrne, MD, 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.

Reviewed by Louise Chang
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