Utilization of medical services and quality of life among low-income patients with generalized anxiety disorder attending primary care clinics

Objective: Anxiety disorders appear to influence morbidity and medical util ization. However, little is known about the relationship between Generalize d Anxiety Disorder, quality of life, and medical utilization, especially am ong low-income patients. The goals of this investigation were to 1) determi ne if low-income patients with GAD utilize medical services more than patie nts with other Axis I diagnoses, or no psychopathology, and 2) compare the health-related quality of life of these three groups. Method Participants w ere randomly recruited from public primary care clinics and administered in take assessments of demographics, stress, and health-related self-report qu estionnaires. At the end of the first year a structured psychiatric intervi ew was administered (N = 431). Over the second year, patients (n = 360) wer e administered a health-related quality of life measure every three months for four assessments. Medical charts were abstracted to collect information about chronic illnesses and visits to outpatient clinics and the emergency department during the two years. Results: Patients were predominantly midd le-aged, low-income, uninsured African-American females. In this low-income sample, patients with GAD utilized the emergency department more and repor ted poorer quality of life than patients with other Axis I disorders and pa tients without any psychopathology. Conclusion: Low-income patients with GA D utilize the emergency department more and report poorer quality of life t han patients with other Axis I disorders and patients without any psychopat hology. Programs to identify and treat patients with GAD may yield improvem ents in quality of life, as well as reduce emergency department utilization .