Symptomatic severity of PRIME-MD diagnosed episodes of panic and generalized anxiety disorder in primary care.
BACKGROUND
Panic disorder (PD) and generalized anxiety disorder (GAD) are often unrecognized by primary care physicians (PCPs). The Primary Care Evaluation of Mental Disorders (PRIME-MD) has been used as a case-finding instrument for depression. Yet, little is known on its usefulness as a case-finding tool for anxiety disorders within the context of a clinical trial.


OBJECTIVE
To examine the: (1) completion rate of the PRIME-MD by patients approached to enroll in a treatment study for PD and GAD; (2) distribution of anxiety diagnoses generated; (3) severity of PD and GAD episodes thus identified; and (4) level of PCPs' agreement with these diagnoses.


METHODS
Cross-sectional interview.


METHODS
Individuals aged 18 to 64 who presented for care at 4 primary care practices.


METHODS
The PRIME-MD, Structured Interview Guide for the Hamilton Anxiety Rating Scale (SIGH-A), and the Panic Disorder Severity Scale (PDSS).


RESULTS
Of the 6,700 patients who completed the PRIME-MD Patient Questionnaire (PQ), 2,926 (44%) screened positive for an anxiety disorder, and 1,216 (42%) met preliminary study eligibility and consented to the PRIME-MD Anxiety Module. Of these, 619 (51%) had either GAD (308), PD (94), or both (217) disorders. Later, 329 completed a telephone interview. Of these, 59% with GAD and 68% with PD reported moderate or greater levels of anxiety symptoms on the SIGH-A and PDSS, respectively, and PCPs agreed with the PRIME-MD diagnosis for 98% of these patients.


CONCLUSIONS
The PRIME-MD can efficiently screen patients for PD and GAD. Although patients thus identified endorse a wide range of anxiety symptoms, PCPs often agree with the diagnosis.
Rollman
Bruce L
BL
Division of General Internal Medicine, Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. rollmanbl@upmc.edu
Belnap
Bea Herbeck
BH
Mazumdar
Sati
S
Zhu
Fang
F
Kroenke
Kurt
K
Schulberg
Herbert C
HC
Katherine Shear
M
M
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000453:epidemiology; D018579:Patient Selection; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires