title: [Generalized anxiety disorder in primary care. Patterns of healthcare utilization in Germany].
abstract: BACKGROUND
  Generalized Anxiety Disorder (GAD) has been described in community studies as a frequent and costly high utilizer group in the primary care sector. Administrative data supporting this observation are lacking so far.
  
  
  METHODS
  This paper reports utilization and prescription data of a nationally representative sample of over 900 primary care physicians, over 75 million prescriptions and 12-month utilization and prescription patterns of n = 3,340 GAD patients.These are compared to a matched control group without GAD, and without any anxiety or depressive disorder (n = 3,340).
  
  
  RESULTS
  GAD patients in comparison to the matched controls revealed: (1) 2-fold increased primary care, (2) almost 3-fold specialist referrals, (3) almost 2-fold increased overall prescription rates, and (4) 3.5-fold increased sick certificates. However, only 58.3% of GAD patients were treated with any psychotropic medication.
  
  
  CONCLUSIONS
  The data of this administrative-epidemiological cohort study support strongly the view that GAD ranks among the most costly high utilizer patient group in primary care in Germany. However, they are rarely treated according to evidence-based guidelines. The paper discusses these findings by suggesting that comorbid conditions might be a barrier for primary care physicians to initiate existing, more appropriate state of the art treatments.
authors.affiliation: Technische Universität Dresden, Deutschland. wittchen@psychologie.tu-dresden.de
authors.forename: H-U
authors.initials: HU
authors.lastname: Wittchen
authors.forename: S
authors.initials: S
authors.lastname: Härtling
authors.forename: E
authors.initials: E
authors.lastname: Dukes
authors.forename: R
authors.initials: R
authors.lastname: Morlock
authors.forename: J
authors.initials: J
authors.lastname: Edelsberg
authors.forename: G
authors.initials: G
authors.lastname: Oster
authors.forename: A
authors.initials: A
authors.lastname: Berger
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D012737:Sex Factors; D014600:Utilization Review
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents