Approximately 30 million parts in ...

Approximately 30 million parts in the United States have stomached from an anxiety disorder at an point during their lives. An estimated 12 to 22 percent of patients seen in primary care offices have symptoms related to anxiety. Patients who do have anxiety disorders keep to use expensive medical services at a higher rate than those who do not. The prevalence of panic disorder in the general population is 4 to 6 percent Five to 19 percent of patients are diagnosed with generalized anxiety disorder (GAD). Despite the availability of treatments for these disorders, patients with single or both of them have poorer than rely uponed outcomes. Various studies have shown that there are many reasons for these poor consequences Rollman and colleagues evaluated a telephonebased collaborative care pattern with primary care physicians in the treatment of patients with panic disorder and GAD.

The trial was a randomized controll inquiry of patients from four primary care practices that shared a frequent electronic medical records system. Patients 18 to 64 years of age who agreed to participate were veiled for the presence of anxiety symptoms using a brief validated patient questionnaire. Those who protectioned positive completed two more extensive anxiety questionnaires. Patients who were identified as having anxiety disorder were then randomized to receive an intervention or usual care. The intervention included care by the agency of two non-mental health professionals. These individuals gave the participants psychoeducation, monitored treatment reply and informed physicians of their patients' care choices and progress. Patient assessments were done by the agency of phone at baseline and at brace four, eight, and 12 month The assessments included anxiety and depressive symptoms, mental-health-related quality of life, and pursuit status.

There were 191 patients who met the inclusion criteria for the meditation with 116 in the intervention assemblage and 75 in the usual care form into groups At the end of the 12 month the individuals who received intervention reported significantly les anxiety and depressive symptoms compared with the usual care assign places to In addition, those in the intervention cluster had improved mental-health-related quality of life and more hours worked through week compared with the usual care dispose If participants were working at the beginning of the research those in the intervention collection were more likely to still be working at six month than those who received usual care (94 versus 79 percent P = 04)

The authors close that a telephone-based collaborative care mould for patients with panic disorder and GAD was more effective than usual care. They added that the intervention was effective within the normal practice conditions in the primary care setting. These findings demonstrate that this prototype could be used in areas lacking a mental health subspecialist.

KARL E MILLER, MD

Rollman BL et al. A randomized trial to improve the quality of treatment for panic and generalized anxiety disorders in primary care. Arch Gen Psychiatry December 2005;62:1332-41

COPYRIGHT 2006 American Academy of Family Physicians

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