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Generalized Anxiety Disorder in Older Medical Patients: Diagnostic Recognition, Mental Health Management and Service Utilization

  • Jessica Calleo
  • Melinda A. Stanley
  • Anthony Greisinger
  • Oscar Wehmanen
  • Michael Johnson
  • Diane Novy
  • Nancy Wilson
  • Mark Kunik
Article

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, χ2 (2, N = 225) = 4.75, p < .05. Conclusions Most patients with anxiety do not have anxiety or symptoms documented in their medical records.

Keywords

Generalized anxiety disorder Primary care Older patients Database study Medical record review 

Notes

Acknowledgments

This project was supported by Grant Number R01MH053932 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Jessica Calleo
    • 1
  • Melinda A. Stanley
    • 1
    • 2
  • Anthony Greisinger
    • 3
  • Oscar Wehmanen
    • 3
  • Michael Johnson
    • 2
    • 4
  • Diane Novy
    • 5
  • Nancy Wilson
    • 1
    • 2
  • Mark Kunik
    • 1
    • 2
    • 6
    • 7
    • 8
  1. 1.Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonUSA
  2. 2.Houston Center for Quality of Care & Utilization StudiesMichael E DeBakey VAMC (152)HoustonUSA
  3. 3.Kelsey Research FoundationHoustonUSA
  4. 4.Department of Clinical Sciences and Administration, College of PharmacyUniversity of HoustonHoustonUSA
  5. 5.Department of Anesthesiology and Pain MedicineThe University of Texas M.D. Anderson Cancer CenterHoustonUSA
  6. 6.Michael E. DeBakey Veterans Affairs Medical CenterHoustonUSA
  7. 7.VA South Central Mental Illness ResearchEducation and Clinical CenterNorth Little RockUSA
  8. 8.Department of MedicineBaylor College of MedicineHoustonUSA

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