老年内科患者的广泛性焦虑障碍：诊断识别、心理健康管理及服务利用
Generalized anxiety disorder in older medical patients: diagnostic recognition, mental health management and service utilization.
作者信息
Calleo Jessica, Stanley Melinda A, Greisinger Anthony, Wehmanen Oscar, Johnson Michael, Novy Diane, Wilson Nancy, Kunik Mark
机构信息
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
出版信息
J Clin Psychol Med Settings. 2009 Jun;16(2):178-85. doi: 10.1007/s10880-008-9144-5. Epub 2009 Jan 18.
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.
背景
基层医疗医生经常治疗患有广泛性焦虑症的老年人。目的：评估医生对焦虑症的诊断和识别情况，并比较患有广泛性焦虑症的老年人与两个分别患有和未患有其他《精神疾病诊断与统计手册》（DSM）诊断的对照样本之间的医疗服务使用情况。
方法
参与者为一个多专科医疗组织中60岁及以上的患者。对行政数据库和病历进行了为期一年的审查。使用逻辑回归和组间协方差分析来分析医疗服务使用频率的差异。
结果
在患有广泛性焦虑症的老年人中，医生对广泛性焦虑症的诊断率为1.5%，对任何焦虑症的诊断率为9%，对焦虑症状的识别率为34%。在控制了医疗合并症后，与患有和未患有其他精神疾病诊断的患者相比，广泛性焦虑症组的放射科预约次数有所增加，卡方检验（2，N = 225）= 4.75，p < .05。
结论
大多数焦虑症患者在其病历中没有焦虑症或相关症状的记录。
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