Prescribing patterns for depression and anxiety worldwide.
Psychiatric disorders, particularly depression and anxiety, present commonly in primary care worldwide. However, significant variation is seen between countries in the prevalence of these disorders. Differing levels of awareness and recognition due to cultural issues may be important contributing factors in this variation. Overall, roughly half of psychiatric cases presenting in primary care go unrecognized, and one third of cases recognized are misdiagnosed. Although treatment is offered in nearly 60% of recognized cases, it is seldom in the context of a specific diagnosis and is only appropriate in about 5% of cases overall. This article explores the transcultural variation in the recognition, diagnosis, and treatment of depression and anxiety disorders using data from the World Health Organization study on Psychological Problems in General Health Care. Patterns observed in Western societies are compared with those seen in the rest of the world and are discussed with a view to educational needs for primary care physicians.
Lecrubier
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Hĵpital la Salpêtrière, INSERM, Unité 302, Paris, France.
D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D014943:Global Health; D006801:Humans; D006993:Hypnotics and Sedatives; D010821:Physicians, Family / Q000193:education / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012107:Research Design; D012720:Severity of Illness Index; D014944:World Health Organization
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs