title: Diagnostic specificity and mental health service utilization among veterans with newly diagnosed anxiety disorders.
abstract: OBJECTIVE
  This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization.
  
  
  METHODS
  This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization.
  
  
  RESULTS
  Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29).
  
  
  CONCLUSIONS
  Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings.
authors.affiliation: Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center. Electronic address: terrib@bcm.edu.
authors.forename: Terri L
authors.initials: TL
authors.lastname: Barrera
authors.affiliation: Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Juliette M
authors.initials: JM
authors.lastname: Mott
authors.affiliation: Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Hundt
authors.affiliation: Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mignogna
authors.affiliation: Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Hong-Jen
authors.initials: HJ
authors.lastname: Yu
authors.affiliation: Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Stanley
authors.affiliation: Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cully
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology / Q000523:psychology; D016017:Odds Ratio; D010045:Outpatients; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology; D010698:Phobic Disorders / Q000453:epidemiology / Q000523:psychology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Anxiety; Anxiety disorder not otherwise specified; Diagnostic; Mental health service utilization; Veteran