Impact of generalized social anxiety disorder in managed care
Impact of generalized social anxiety disorder in managed care
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DOI：
10.1176/appi.ajp.158.12.1999
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发表时间：
2001-12-01
影响因子：
17.7
通讯作者：
Helstad, CP
中科院分区：
文献类型：
--
作者：
Katzelnick, DJ;Kobak, KA;Helstad, CP
目标：作者确定的费用与广泛性社交焦虑症在管理式护理setting.Method：一个三阶段的邮件和电话调查进行了1998年7月至10月在两个门诊部的一个大型健康维护组织（HMO）。该调查评估了直接成本，间接成本，健康相关的生活质量，与广泛性社交焦虑症的临床严重程度，单独和共病psychopathology.Results：当前广泛性社交焦虑症的加权患病率为8.2%。在过去的一年里，只有0.5%的广泛性社交焦虑症患者被准确诊断。然而，44.1%的人有心理健康专业访问或被开了一种抗抑郁药，43.6%的人被发现患有精神病合并症。非共病的广泛性社交焦虑障碍与显著较低的健康相关生活质量、工作效率和收入以及更高的卫生服务利用率相关;广泛性社交焦虑障碍与共病的精神病理学相关性更大。21.9%的非共病广泛性社交焦虑障碍患者企图自杀。与对照组相比，平均严重程度的广泛性社交焦虑症患者从大学毕业的概率低10个百分点，工资低10%，从事技术、专业或管理工作的概率低14个百分点。结论：在HMO成员的社区队列中，尽管广泛性社交焦虑症非常普遍，并且与显着的直接和间接成本，共病抑郁症和损伤相关，但很少被诊断或治疗。
objective: The authors determined the costs associated with generalized social anxiety disorder in a managed care setting.Method: A three-phase mail and telephone survey was conducted from July to October 1998 in two outpatient clinics of a large health maintenance organization (HMO). The survey assessed direct costs, indirect costs, health-related quality of life, and clinical severity associated with generalized social anxiety disorder, both alone and with comorbid psychopathology.Results: The weighted prevalence rate of current generalized social anxiety disorder was 8.2%. In the past year, only 0.5% of subjects with generalized social anxiety disorder had been accurately diagnosed. Yet 44.1% had a mental health specialty visit or had been prescribed an antidepressant, and psychiatric comorbidity was found in 43.6%. Noncomorbid generalized social anxiety disorder was associated with significantly lower health-related quality of life, work productivity, and earnings and greater utilization of health services; generalized social anxiety disorder with comorbid psychopathology was even more disabling. Suicide was attempted by 21.9% of subjects with noncomorbid generalized social anxiety disorder. Persons with average-severity generalized social anxiety disorder had probabilities of graduating from college that were 10 percentage points lower, earned wages that were 10% lower, and had probabilities of holding a technical, professional, or managerial job that were 14 percentage points lower than the comparison group.Conclusions: In a community cohort of HMO members, generalized social anxiety disorder was rarely diagnosed or treated despite being highly prevalent and associated with significant direct and indirect costs, comorbid depression, and impairment.