title: Psychiatric treatment in primary care patients with anxiety disorders: a comparison of care received from primary care providers and psychiatrists.
abstract: OBJECTIVE
  This study examined psychiatric treatment received by primary care patients with anxiety disorders and compared treatment received from primary care physicians and from psychiatrists.
  
  
  METHODS
  Primary care patients at 15 sites were screened for anxiety symptoms. Those screening positive were interviewed to assess for anxiety disorders. Information on psychiatric treatment received and provider of pharmacological treatment were collected.
  
  
  RESULTS
  Of 539 primary care participants with at least one anxiety disorder, almost half (47.3%) were untreated. Nearly 21% were receiving medication only for psychiatric problems, 7.2% were receiving psychotherapy alone, and 24.5% were receiving both medication and psychotherapy. Patients receiving psychopharmacological treatment received similar medications, often at similar dosages, regardless of whether their prescriber was a primary care physician or a psychiatrist. One exception was that patients were less likely to be taking benzodiazepines if their provider was a primary care physician. Those receiving medications from a primary care provider were also less likely to be receiving psychotherapy. Overall, patients with more functional impairment, more severe symptoms, and comorbid major depression were more likely to receive mental health treatment. Members of racial/ethnic minority groups were less likely to be treated. Frequently endorsed reasons for not receiving pharmacological treatment were that the primary care physician did not recommend it and the patient did not believe in taking medication for emotional problems.
  
  
  CONCLUSIONS
  Nearly half the primary care patients with anxiety disorders were not treated. However, when they were treated, the care received from primary care physicians and psychiatrists was relatively similar.
authors.affiliation: Department of Psychiatry, Brown University, Providence, RI 02096, USA. risa_weisberg@brown.edu
authors.forename: Risa B
authors.initials: RB
authors.lastname: Weisberg
authors.forename: Ingrid
authors.initials: I
authors.lastname: Dyck
authors.forename: Larry
authors.initials: L
authors.lastname: Culpepper
authors.forename: Martin B
authors.initials: MB
authors.lastname: Keller
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001008:Anxiety Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D001294:Attitude to Health; D003131:Combined Modality Therapy; D003695:Delivery of Health Care; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010821:Physicians, Family / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011570:Psychiatry / Q000379:methods* / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000379:methods*; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016312:Treatment Refusal / Q000523:psychology
chemical_list: D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors