title: Treatment adequacy of anxiety disorders among young adults in Finland.
abstract: BACKGROUND
  Anxiety disorders are common in early adulthood, but general population studies concerning the treatment adequacy of anxiety disorders taking into account appropriate pharmacological and psychological treatment are scarce. The aims of this study were to examine treatments received for anxiety disorders in a Finnish general population sample of young adults, and to define factors associated with receiving minimally adequate treatment and with dropping out from treatment.
  
  
  METHODS
  A questionnaire containing several mental health screens was sent to a nationally representative two-stage cluster sample of 1894 Finns aged 19 to 34 years. All screen positives and a random sample of screen negatives were invited to a mental health assessment including a SCID interview. For the final diagnostic assessment, case records from mental health treatments for the same sample were obtained. This article investigates treatment received, treatment adequacy and dropouts from treatment of 79 participants with a lifetime anxiety disorder (excluding those with a single specific phobia). Based on all available information, receiving antidepressant or buspirone medication for at least 2 months with at least four visits with any type of physician or at least eight sessions of psychotherapy within 12 months or at least 4 days of hospitalization were regarded as minimally adequate treatment for anxiety disorders. Treatment dropout was rated if the patient discontinued the visits by his own decision despite having an adequate treatment strategy according to the case records.
  
  
  RESULTS
  Of participants with anxiety disorders (excluding those with a single specific phobia), 41.8 % had received minimally adequate treatment. In the multivariate analysis, comorbid substance use disorder was associated with antidepressant or buspirone medication lasting at least 2 months. Those who were currently married or cohabiting had lower odds of having at least four visits with a physician a year. None of these factors were associated with the final outcome of minimally adequate treatment or treatment dropout. Participants with comorbid personality disorders received and misused benzodiazepines more often than others.
  
  
  CONCLUSIONS
  More efforts are needed to provide adequate treatment for young adults with anxiety disorders. Attention should be paid to benzodiazepine prescribing to individuals with personality disorders.
authors.affiliation: Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland. teija.kasteenpohja@thl.fi.|Faculty of Medicine, University of Helsinki, Helsinki, Finland. teija.kasteenpohja@thl.fi.
authors.forename: Teija
authors.initials: T
authors.lastname: Kasteenpohja
authors.affiliation: Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland.|Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Mauri
authors.initials: M
authors.lastname: Marttunen
authors.affiliation: The Social Insurance Institute, Helsinki, Finland.
authors.forename: Terhi
authors.initials: T
authors.lastname: Aalto-Setälä
authors.affiliation: Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland.|Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Jonna
authors.initials: J
authors.lastname: Perälä
authors.affiliation: Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland.|Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Samuli I
authors.initials: SI
authors.lastname: Saarni
authors.affiliation: Department Health, Mental Health Unit, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland.|Department of Social Psychiatry, School of Public Health, University of Tampere, Tampere, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Suvisaari
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000628:therapy*; D002065:Buspirone / Q000627:therapeutic use*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000379:methods* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D002065:Buspirone
keywords: Anxiety disorders; Epidemiology; Quality of care; Young adults