Bélanger Lynda, Ladouceur Robert, Morin Charles M
Ecole de Psychologie, Centre de Recherche Robert-Giffard, Laval University in Quebec City, Que.
Can Fam Physician. 2005 Oct;51(10):1362-3.
To examine self-reported health care use and health care-seeking behaviour of patients meeting DSM-IV's diagnostic criteria for generalized anxiety disorder (GAD).
Survey of outpatients recruited at three different times of the day using questionnaires on worry and anxiety (a six-item screening questionnaire based on DSM-IV criteria for GAD), on perceived health problems, and on health care use and health care-seeking behaviour. The assessment package also included well validated assessment instruments for insomnia and depression symptoms. All patients seeking health care were invited to participate. Participants completed the survey as they waited in the reception area.
Four randomly selected community-based medical clinics of Quebec city's metropolitan area.
A final sample of 1110 patients among 1878 outpatients invited to participate included 219 (19.7%) who tested positive for GAD.
Self-reported worry and anxiety (based on DSM-IV criteria for GAD), self-perceived health problems, health care use and health care-seeking behaviour, insomnia, and symptoms of depression.
Participants who tested positive on a screening test for GAD reported more annual medical visits (5.3 versus 3.4) than other patients. Those who reported at least five annual medical visits were nearly four times more likely to have positive results for GAD. Women were 1.6 times more likely to have positive results than men were. Patients who tested positive reported insomnia-type sleep disturbances, depressive symptoms, fatigue, and gastric problems significantly more often than others. Forty-two percent had consulted a family physician in the past year with a complaint of anxiety. Eighty percent of patients who tested positive reported they believed they had an anxiety problem, and this belief predicted positive test results (odds ratio = 20.3). Yet most reported not having sought other types of medical or psychological care specifically for anxiety in the past year.
Some patients in this sample with symptoms of GAD mainly seek primary care for their symptoms. Questions about excessive worrying and anxiety, as part of routine examination, can increase recognition of GAD.
研究符合《精神疾病诊断与统计手册》第四版（DSM-IV）广泛性焦虑症（GAD）诊断标准的患者自我报告的医疗保健利用情况及就医行为。
对一天中三个不同时段招募的门诊患者进行调查，使用关于担忧和焦虑（一份基于DSM-IV的GAD标准的六项筛查问卷）、感知到的健康问题以及医疗保健利用和就医行为的问卷。评估包还包括经过充分验证的失眠和抑郁症状评估工具。所有寻求医疗保健的患者均被邀请参与。参与者在候诊区等待时完成调查。
魁北克市大都市区随机选取的四家社区医疗诊所。
在1878名受邀参与的门诊患者中，最终样本为1110名患者，其中219名（19.7%）GAD检测呈阳性。
自我报告的担忧和焦虑（基于DSM-IV的GAD标准）、自我感知的健康问题、医疗保健利用和就医行为、失眠以及抑郁症状。
GAD筛查检测呈阳性的参与者报告的年度就诊次数（5.3次对3.4次）比其他患者更多。报告每年至少就诊五次的患者GAD检测呈阳性的可能性几乎是其他患者的四倍。女性检测呈阳性的可能性是男性的1.6倍。检测呈阳性的患者报告失眠型睡眠障碍、抑郁症状、疲劳和胃部问题的频率明显高于其他患者。42%的患者在过去一年因焦虑问题咨询过家庭医生。80%检测呈阳性的患者报告他们认为自己有焦虑问题，而这种认知可预测检测呈阳性结果（优势比 = 20.3）。然而，大多数患者报告在过去一年中并未专门因焦虑寻求其他类型的医疗或心理护理。
该样本中一些有GAD症状的患者主要因症状寻求初级保健。作为常规检查的一部分，询问过度担忧和焦虑问题可提高对GAD的识别率。
