Generalized anxiety disorder in older medical patients: diagnostic recognition, mental health management and service utilization.
BACKGROUND
Primary care physicians often treat older adults with Generalized Anxiety Disorder. Objective To estimate physician diagnosis and recognition of anxiety and compare health service use among older adults with GAD with two comparison samples with and without other DSM diagnoses.


METHODS
Participants were 60+ patients of a multi-specialty medical organization. Administrative database and medical records were reviewed for a year. Differences in frequency of health service use were analyzed with logistic regression and between-subjects analysis of covariance.


RESULTS
Physician diagnosis of GAD was 1.5% and any anxiety was 9%, and recognition of anxiety symptoms was 34% in older adults with GAD. After controlling for medical comorbidity, radiology appointments were increased in the GAD group relative to those with and without other psychiatric diagnoses, chi(2) (2, N = 225) = 4.75, p < .05.


CONCLUSIONS
Most patients with anxiety do not have anxiety or symptoms documented in their medical records.
Calleo
Jessica
J
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Stanley
Melinda A
MA
Greisinger
Anthony
A
Wehmanen
Oscar
O
Johnson
Michael
M
Novy
Diane
D
Wilson
Nancy
N
Kunik
Mark
M
D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D013781:Texas; D014600:Utilization Review / Q000706:statistics & numerical data
D011619:Psychotropic Drugs