سن و تفاوت های نژادی در ارائه و درمان اختلال اضطراب فراگیر در مراقبت های اولیه
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|35019||2008||9 صفحه PDF||سفارش دهید||5717 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Journal of Anxiety Disorders, Volume 22, Issue 7, October 2008, Pages 1128–1136
Despite the prevalence and impact of Generalized Anxiety Disorder (GAD) in the primary care setting, little is known about its presentation in this setting. The purpose of this study is to examine age and racial differences in the presentation and treatment of GAD in medical patients. Participants were recruited from one family medicine clinic and one internal medicine clinic. The prevalence of GAD was lowest for older adults. Age differences were found in the presentation of GAD, with young adults reporting greater cognitive symptoms of anxiety, negative affect, and depressive symptoms. African-Americans with GAD reported more positive affect and lower rates of treatment. The lower levels of negative affect and depressive symptoms reported among older adults may affect the recognition of GAD by primary care physicians. Further research is needed to better understand the causes of racial differences in treatment.
Generalized Anxiety Disorder (GAD) is characterized by excessive and uncontrollable worry lasting for at least 6 months and at least 3 of the following symptoms: feeling restless, keyed up, or on edge; fatigue; impaired concentration; irritability; muscle tension; and sleep disturbance (APA, 2000). Results of the National Comorbidity Survey-Replication (NCS-R) indicate a lifetime prevalence for GAD of 5.7% (Kessler et al., 2005). GAD is associated with both emotional and physical symptoms and impairments in quality of life; these impairments are comparable to those experienced by persons with major depression and physical conditions, and greater than those associated with substance abuse. It is also associated with significant economic burden, through higher use of medical services and missed workdays (for a review, see Hoffman, Dukes, & Wittchen, in press). Understanding GAD within the context of primary care settings is important. The prevalence of GAD is higher in the primary care setting than in community-based epidemiological studies, with rates as high as 14.8% (Olfson et al., 2000), and when anxiety is comorbid with a physical condition, even greater impairments in quality of life and disability result (Katon, Lin, & Kroenke, 2007; Sareen et al., 2006). Anxiety is characterized by a number of somatic symptoms which may be easily mistaken for a medical problem. Also, anxious patients in a primary care setting are likely to present with a complex constellation of symptoms, as anxiety is often associated with unexplained medical symptoms (Katon, Sullivan, & Walker, 2001; Kroenke et al., 1994). All of these factors contribute to the lack of recognition and undertreatment of anxiety in the primary care setting (Kessler, Lloyd, Lewis, & Gray, 1999; Lowe et al., 2003; Young, Klap, Sherbourne, & Wells, 2001).