title: Generalized anxiety disorder in older medical patients: diagnostic recognition, mental health management and service utilization.
abstract: 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.
authors.affiliation: Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Calleo
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Stanley
authors.forename: Anthony
authors.initials: A
authors.lastname: Greisinger
authors.forename: Oscar
authors.initials: O
authors.lastname: Wehmanen
authors.forename: Michael
authors.initials: M
authors.lastname: Johnson
authors.forename: Diane
authors.initials: D
authors.lastname: Novy
authors.forename: Nancy
authors.initials: N
authors.lastname: Wilson
authors.forename: Mark
authors.initials: M
authors.lastname: Kunik
mesh_terms: 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
chemical_list: D011619:Psychotropic Drugs