title: Service utilization among veterans with schizophrenia and a comorbid anxiety disorder.
abstract: OBJECTIVE
  The objective was to assess the prevalence and impact of anxiety disorders on service utilization among Veterans Health Administration (VHA) patients with schizophrenia.
  
  
  METHODS
  This cross-sectional study examined diagnostic, utilization, and medication records included in the VHA National Psychosis Registry. Relationships between schizophrenia and anxiety disorders were evaluated along demographic and service utilization dimensions.
  
  
  RESULTS
  During fiscal year 2011, 23.8% (N=20,722) of 87,006 VHA patients with schizophrenia were diagnosed as having a comorbid anxiety disorder; 15.2% of the sample had a posttraumatic stress disorder (PTSD) diagnosis and 8.6% a non-PTSD anxiety disorder. Comorbid anxiety disorders were associated with increased psychiatric comorbidity (depression, personality disorder, and substance use disorder), higher rates of psychiatric and medical hospitalization, and increased utilization of outpatient mental health services.
  
  
  CONCLUSIONS
  Anxiety disorders are common among individuals with schizophrenia within the VHA and appeared in this study to convey additional disability in terms of psychiatric comorbidity and the need for increased psychiatric care. Future research should investigate ways to improve detection and enhance treatment provided to this population.
authors.affiliation: At the time of the study, all authors were with Health Services Research and Development, U.S. Department of Veterans Affairs (VA) Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan (e-mail: denis.birgenheir@va.gov ). Dr. Birgenheir is now with the Mental Health Department, VA Nebraska-Western Iowa Healthcare System, Omaha, Nebraska.
authors.forename: Denis G
authors.initials: DG
authors.lastname: Birgenheir
authors.forename: Dara
authors.initials: D
authors.lastname: Ganoczy
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Bowersox
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000150:complications / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012042:Registries; D012559:Schizophrenia / Q000150:complications / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*