Failing of Primary Care: Some SAD Patients Not Getting Proper Treatment

Article excerpt

NEW ORLEANS -- Only 57% of primary care patients who have social anxiety disorder receive treatment, according to research presented at the annual meeting of the American Academy of Family Physicians.

Overall, 20% of patients with social anxiety disorder (SAD) in this setting were treated with medication only, 4% were treated with psychotherapy only, and 33% were treated with both, said Kristin M. Maki, Ph.D., of Brown University, Providence, R.I.

A total of 539 patients meeting the DSM-IV criteria for one or more intake anxiety disorders were recruited from 15 primary care, general internal medicine, and family medicine clinics in New England to take part in the Primary Care Anxiety Project. Follow-up interviews are performed every year.

SAD was the second most common anxiety disorder among these patients, accounting for 33% (179), following post-traumatic stress disorder (37%).

"This was a group with a high degree of psychiatric comorbidity," according to Dr. Maki.

Major depressive disorder was the most common comorbid condition (45%). In terms of the clinical course, only 33% were likely to recover after 4 years.

SAD is characterized by a marked fear of social and performance situations and the fear of humiliation and embarrassment. The lifetime prevalence of SAD is 13%, making it the third most common psychiatric disorder after depression and substance abuse.

SAD has an earlier age of onset than the other anxiety disorders and has a chronic course.

"Combine these two facts and this means that SAD has the potential to have a pervasive and detrimental impact across all aspects of a person's life," Dr. Maki said.

Even without comorbidity, the lifetime risk of suicide attempts is almost four times greater among people with SAD than in the general population. …