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Recognizing and managing anxiety disorders in primary health care in Turkey.

Kartal M, Coskun O, Dilbaz N - BMC Fam Pract (2010)

Bottom Line: For all three cases, GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy.The referral rate to a psychiatrist was between 23.1 and 30.6%.The percentages of the prescription of selective serotonin reuptake inhibitors (SSRI) in accurate diagnosis were 59.3 for social phobia, 33.3 for GAD, and 55.5 for OCD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Family Medicine Department of Dokuz Eylul University, 35340, Inciralti, Izmir, Turkey. mehtapkartal@gmail.com

ABSTRACT

Background: Anxiety disorders are common and are frequently not diagnosed accurately in primary care. Our aim was to determine the knowledge gaps of general practitioners (GPs) in the diagnosis and treatment of anxiety disorders by using vignettes.

Methods: A cross-sectional survey was completed with 255 primary care physicians (response rate 59.4%) in Manisa, a city in western Turkey. From the postal questionnaire, information on working experience, postgraduate education in psychiatry, the interests of the physicians in psychiatry were obtained. The physicians' diagnosis and treatment preferences for generalized anxiety disorder (GAD), social phobia (SP), and obsessive compulsive disorder (OCD) were determined through clinical vignettes prepared for data collection.

Results: Two hundred and twenty-seven (89.0%) out of 255 GPs included the diagnosis of obsessive compulsive disorder in their differential diagnosis; however, the rates for social phobia and generalized anxiety disorder were 69.4% (n = 177) and 22.3% (n = 57), respectively. GPs with a post-graduate education on psychiatry diagnosed vignettes more accurately for OCD (p = 0.04). For all three cases, GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy. The referral rate to a psychiatrist was between 23.1 and 30.6%. The percentages of the prescription of selective serotonin reuptake inhibitors (SSRI) in accurate diagnosis were 59.3 for social phobia, 33.3 for GAD, and 55.5 for OCD.

Conclusions: There is a gap of knowledge in GPs, which leads to poor recognition and management of anxiety disorders in primary care. Effective interventions including post-graduate education and updated guidelines on anxiety disorders should be planned and implemented with their assessments by vignettes.

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GPs' treatment choices for the vignettes according to the accuracy of the diagnosis.
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Figure 1: GPs' treatment choices for the vignettes according to the accuracy of the diagnosis.

Mentions: The treatment preferences of the GPs for the vignettes, according to the accuracy of their diagnosis, were shown in Figure 1. For all three vignettes diagnosed accurately, the GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy. There was no significant relationship between the gender and the age of the GPs and the treatment options (p > 0.05). The referral rates of the male GPs were 29.0% and 36.6% for GAD (p = 0.007) and OCD (p = 0.02), respectively, which were higher than those of the female GPs (14.5% and 22.7%). The GPs with a post-graduate education and interest in psychiatry prefer referral for OCD (20.2%; 17.7%), which were lower than those with no education (38.4%; p = 0.002) and interest (38.4%; p = 0.0001). For GAD, this is also true with percentages of 8.3% and 33.6% for post-graduate education (p = 0.0001) and 15.6% and 27.0% for interest in psychiatry (p = 0.045), respectively.


Recognizing and managing anxiety disorders in primary health care in Turkey.

Kartal M, Coskun O, Dilbaz N - BMC Fam Pract (2010)

GPs' treatment choices for the vignettes according to the accuracy of the diagnosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2874786&req=5

Figure 1: GPs' treatment choices for the vignettes according to the accuracy of the diagnosis.
Mentions: The treatment preferences of the GPs for the vignettes, according to the accuracy of their diagnosis, were shown in Figure 1. For all three vignettes diagnosed accurately, the GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy. There was no significant relationship between the gender and the age of the GPs and the treatment options (p > 0.05). The referral rates of the male GPs were 29.0% and 36.6% for GAD (p = 0.007) and OCD (p = 0.02), respectively, which were higher than those of the female GPs (14.5% and 22.7%). The GPs with a post-graduate education and interest in psychiatry prefer referral for OCD (20.2%; 17.7%), which were lower than those with no education (38.4%; p = 0.002) and interest (38.4%; p = 0.0001). For GAD, this is also true with percentages of 8.3% and 33.6% for post-graduate education (p = 0.0001) and 15.6% and 27.0% for interest in psychiatry (p = 0.045), respectively.

Bottom Line: For all three cases, GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy.The referral rate to a psychiatrist was between 23.1 and 30.6%.The percentages of the prescription of selective serotonin reuptake inhibitors (SSRI) in accurate diagnosis were 59.3 for social phobia, 33.3 for GAD, and 55.5 for OCD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Family Medicine Department of Dokuz Eylul University, 35340, Inciralti, Izmir, Turkey. mehtapkartal@gmail.com

ABSTRACT

Background: Anxiety disorders are common and are frequently not diagnosed accurately in primary care. Our aim was to determine the knowledge gaps of general practitioners (GPs) in the diagnosis and treatment of anxiety disorders by using vignettes.

Methods: A cross-sectional survey was completed with 255 primary care physicians (response rate 59.4%) in Manisa, a city in western Turkey. From the postal questionnaire, information on working experience, postgraduate education in psychiatry, the interests of the physicians in psychiatry were obtained. The physicians' diagnosis and treatment preferences for generalized anxiety disorder (GAD), social phobia (SP), and obsessive compulsive disorder (OCD) were determined through clinical vignettes prepared for data collection.

Results: Two hundred and twenty-seven (89.0%) out of 255 GPs included the diagnosis of obsessive compulsive disorder in their differential diagnosis; however, the rates for social phobia and generalized anxiety disorder were 69.4% (n = 177) and 22.3% (n = 57), respectively. GPs with a post-graduate education on psychiatry diagnosed vignettes more accurately for OCD (p = 0.04). For all three cases, GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy. The referral rate to a psychiatrist was between 23.1 and 30.6%. The percentages of the prescription of selective serotonin reuptake inhibitors (SSRI) in accurate diagnosis were 59.3 for social phobia, 33.3 for GAD, and 55.5 for OCD.

Conclusions: There is a gap of knowledge in GPs, which leads to poor recognition and management of anxiety disorders in primary care. Effective interventions including post-graduate education and updated guidelines on anxiety disorders should be planned and implemented with their assessments by vignettes.

Show MeSH
Related in: MedlinePlus