MIDAS Project Publication Abstracts
Zimmerman, M., Chelminski, I. Clinician recognition of anxiety
disorders in depressed outpatients. Journal of Psychiatric Research,
in press.
Objective: The recognition of anxiety disorders in depressed
patients has potential clinical significance because their presence
predicts poorer outcome and may influence treatment selection. In
routine clinical settings, an unstructured diagnostic interview
is typically used to assess patients at the initiation of treatment.
Unstructured interviews, however, may result in missed diagnoses,
with potential negative clinical consequences. The goals of the
present study were to examine whether anxiety disorders are less
frequently identified using a routine unstructured clinical evaluation
than a semi-structured diagnostic interview in patients with a principal
diagnosis of major depressive disorder (MDD), and to determine patients'
desire for treatment for comorbid anxiety disorders. Methods:
Psychiatric outpatients with MDD were evaluated with either a semi-structured
or an unstructured diagnostic interview. Current DSM-IV anxiety
disorder diagnoses were compared in the two, non-overlapping groups
of depressed psychiatric outpatients seen in the same practice setting.
Patients with comorbid anxiety disorders who were interviewed with
the semi-structured interview were asked if they wanted treatment
to address their anxiety symptoms. Results: Individuals interviewed
with the semi-structured interview were diagnosed with significantly
more current anxiety disorders than individuals who were assessed
with an unstructured interview. There was variability in patients'
desire for treatment of the different anxiety disorders, though
for each disorder the majority of patients wanted treatment to address
the anxiety symptoms. Conclusion: In psychiatric outpatients
with a principal diagnosis of MDD psychiatrists underrecognize anxiety
disorder comorbidity for which patients want treatment.
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