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Generalized anxiety disorder in older medical patients: diagnostic recognition, mental health management and service utilization.

Calleo J, Stanley MA, Greisinger A, Wehmanen O, Johnson M, Novy D, Wilson N, Kunik M. Generalized anxiety disorder in older medical patients: diagnostic recognition, mental health management and service utilization. Journal of Clinical Psychology in Medical Settings. 2009 Jun 1; 16(2):178-85.

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Abstract:

BACKGROUND: Primary care physicians often treat older adults with Generalized Anxiety Disorder. Objective To estimate physician diagnosis and recognition of anxiety and compare health service use among older adults with GAD with two comparison samples with and without other DSM diagnoses. METHODS: Participants were 60+ patients of a multi-specialty medical organization. Administrative database and medical records were reviewed for a year. Differences in frequency of health service use were analyzed with logistic regression and between-subjects analysis of covariance. RESULTS: Physician diagnosis of GAD was 1.5% and any anxiety was 9%, and recognition of anxiety symptoms was 34% in older adults with GAD. After controlling for medical comorbidity, radiology appointments were increased in the GAD group relative to those with and without other psychiatric diagnoses, chi(2) (2, N = 225) = 4.75, p < .05. CONCLUSIONS: Most patients with anxiety do not have anxiety or symptoms documented in their medical records.




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