Untreated anxiety among adult primary care patients in a Health Maintenance Organization.
BACKGROUND
Untreated anxiety may be particularly difficult for primary care physicians to recognize and diagnose because there are no reliable demographic or medical profiles for patients with this condition and because these patients present with a high rate of comorbid psychological conditions that complicate selection of treatment.


METHODS
A prospective assessment of untreated anxiety symptoms and disorders among primary care patients.


RESULTS
Approximately 10% of eligible patients screened in clinic waiting rooms of a mixed-model health maintenance organization reported elevated symptoms and/or disorders of anxiety that were unrecognized and untreated. These patients with untreated anxiety reported significantly worse functioning on both physical and emotional measures than "not anxious" comparison patients; in fact these patients reported reduced functioning levels within ranges that would be expected for patients with chronic physical diseases, such as diabetes and congestive heart failure. The most severe reductions in functioning were reported by untreated patients whose anxiety was mixed with depression symptoms or disorders.


CONCLUSIONS
Primary care physicians may benefit from screening tools and consultations by mental health specialists to assist in recognition and diagnosis of anxiety symptoms and disorders alone and mixed with depression.
Fifer
S K
SK
Technology Assessment Group Inc., San Francisco, Calif.
Mathias
S D
SD
Patrick
D L
DL
Mazonson
P D
PD
Lubeck
D P
DP
Buesching
D P
DP
D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012917:Social Adjustment; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy