TREATMENT TYPICALLY PROVIDED FOR COMORBID ANXIETY DISORDERS

Objective: To study whether the extent and type of treatment for comor bid anxiety disorders Varies for patients with depression, hypertensio n, diabetes, and heart disease treated by general medical clinicians. Methods: Data are from 2189 general medical patients with and without comorbid anxiety disorders in the Medical Outcomes Study. Treatment da ta were based on clinician reports of counseling provided during a vis it and patient reports of recent medication use. Results: Patients wit h comorbid anxiety disorders were more likely to receive treatments fo r anxiety disorders than those without anxiety disorders. Among those with anxiety disorders, the use of psychosocial counseling and psychot ropic medication was greater for patients with depression than for pat ients without depression who had chronic medical conditions. Minor tra nquilizers were used more commonly than antidepressants, regardless of the type of comorbid condition. Among patients with anxiety disorders , those visiting medical subspecialists were more likely to use minor tranquilizers than those visiting family practitioners or internists. Patients of family physicians with chronic medical conditions (but not with depression) were less likely than similar patients of internists to use minor tranquilizers whether or not anxiety disorders were pres ent. Conclusions: Anxiety disorders co-occurring with another disease (medical illness or depression) increases the likelihood of counseling and the use of psychotropic medication in the general medical sector. Patients with a chronic medical illness with or without comorbid anxi ety disorders visiting family physicians are less likely to use minor tranquilizers than those visiting subspecialists or internists.