Psychiatric treatment in primary care patients with anxiety disorders: a comparison of care received from primary care providers and psychiatrists.
Psychiatric treatment in primary care patients with anxiety disorders: a comparison of care received from primary care providers and psychiatrists.
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患有焦虑症的初级保健患者的精神病治疗：初级保健提供者和精神科医生接受的护理的比较。
DOI：
10.1176/ajp.2007.164.2.276
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Keller,MartinB
中科院分区：
文献类型：
--
作者：
Weisberg,RisaB;Dyck,Ingrid;Culpepper,Larry;Keller,MartinB
本研究探讨了精神科治疗的初级保健患者焦虑症和比较治疗初级保健医生和精神科医生。MethodPrimary care patients at 15 sites were screened for anxiety symptoms.那些筛查阳性的人接受了采访，以评估焦虑症。收集了有关接受的精神科治疗和药物治疗提供者的信息。结果在539名至少患有一种焦虑症的初级保健参与者中，几乎一半（47.3%）未经治疗。近21%的人只接受精神问题药物治疗，7.2%的人只接受心理治疗，24.5%的人同时接受药物和心理治疗。接受精神药理学治疗的患者接受了类似的药物，通常剂量相似，无论他们的处方者是初级保健医生还是精神科医生。一个例外是，如果患者的提供者是初级保健医生，则患者不太可能服用苯二氮卓类药物。那些从初级保健提供者那里接受药物治疗的人也不太可能接受心理治疗。总的来说，功能障碍更严重、症状更严重和共病重度抑郁症的患者更有可能接受心理健康治疗。少数种族/族裔群体的成员不太可能受到治疗。经常认可的原因，不接受药物治疗的初级保健医生不建议，病人不相信服用药物治疗情绪problems.ConclusionsNearly一半的初级保健焦虑症患者没有治疗。然而，当他们接受治疗时，从初级保健医生和精神科医生那里得到的护理相对相似。
ObjectiveThis study examined psychiatric treatment received by primary care patients with anxiety disorders and compared treatment received from primary care physicians and from psychiatrists.MethodPrimary care patients at 15 sites were screened for anxiety symptoms. Those screening positive were interviewed to assess for anxiety disorders. Information on psychiatric treatment received and provider of pharmacological treatment were collected.ResultsOf 539 primary care participants with at least one anxiety disorder, almost half (47.3%) were untreated. Nearly 21% were receiving medication only for psychiatric problems, 7.2% were receiving psychotherapy alone, and 24.5% were receiving both medication and psychotherapy. Patients receiving psychopharmacological treatment received similar medications, often at similar dosages, regardless of whether their prescriber was a primary care physician or a psychiatrist. One exception was that patients were less likely to be taking benzodiazepines if their provider was a primary care physician. Those receiving medications from a primary care provider were also less likely to be receiving psychotherapy. Overall, patients with more functional impairment, more severe symptoms, and comorbid major depression were more likely to receive mental health treatment. Members of racial/ethnic minority groups were less likely to be treated. Frequently endorsed reasons for not receiving pharmacological treatment were that the primary care physician did not recommend it and the patient did not believe in taking medication for emotional problems.ConclusionsNearly half the primary care patients with anxiety disorders were not treated. However, when they were treated, the care received from primary care physicians and psychiatrists was relatively similar.