Treatment of anxiety disorders in the Finnish general population.
BACKGROUND
Treatments for anxiety disorders in the general population are not widely investigated. We determined the proportion, type and determinants of treatment in the Finnish general population.


METHODS
Within the Health 2000 Study, a representative sample (n = 6005) of adults (age > 30 years) were interviewed in 2000-2001 with the Composite International Diagnostic Interview (M-CIDI) to assess the presence of DSM-IV mental disorders during the preceding 12 months. Logistic regression models were used to examine factors influencing the type of treatment (pharmacotherapy and/or psychological treatment) and also the types of pharmacotherapy (antidepressants, anxiolytics, or sedatives and hypnotics) used for anxiety disorders.


RESULTS
For individuals with an anxiety disorder, 40% (95/229) currently used psychotropic medication, 23% (55/229) used antidepressants, 19% (44/229) anxiolytics and 17% (41/229) sedatives or hypnotics. Of those using health care services for mental health reasons (34%, 76/229), 80% (61/76) received pharmacotherapy. Only 45% (34/76) reported having psychological treatment, with few having more than 4 visits (27%, 20/76). Living in a semi-urban environment, retirement and high perceived disability increased the likelihood of pharmacotherapy-only treatment; higher education and comorbidity with mood disorders increased the likelihood of psychological treatment. General practitioners more often than psychiatrists provided pharmacotherapy treatment alone (67% vs. 34%, p < 0.05), particularly anxiolytics or sedatives.


CONCLUSIONS
Use of mental health services and psychological treatment were based on self-reports. No data on duration of pharmacotherapy was available.


CONCLUSIONS
Anxiety disorders remain largely untreated in the general population. Among those seeking treatment, pharmacotherapy predominates, whereas even brief psychotherapies are rare. Contrary to clinical guidelines, anxiolytics and sedatives are commonly used instead of antidepressants.
Sihvo
Sinikka
S
STAKES, National Research and Development Centre for Welfare and Health, P.O. Box 220, 00531 Helsinki, Finland. sinikka.sihvo@stakes.fi
Hämäläinen
Juha
J
Kiviruusu
Olli
O
Pirkola
Sami
S
Isometsä
Erkki
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005387:Finland; D019983:Guideline Adherence; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011159:Population Surveillance; D017410:Practice Guidelines as Topic; D011570:Psychiatry / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives