Terri L Barrera1, Juliette M Mott2, Natalie E Hundt2, Joseph Mignogna2, Hong-Jen Yu2, Melinda A Stanley2, Jeffrey A Cully2. 1. Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center. Electronic address: terrib@bcm.edu. 2. Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center.
Abstract
OBJECTIVE: This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization. METHOD: This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization. RESULTS: Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29). CONCLUSION: Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings. Published by Elsevier Inc.
OBJECTIVE: This study examined rates of specific anxiety diagnoses (posttraumatic stress disorder, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and specific phobia) and anxiety disorder not otherwise specified (anxiety NOS) in a national sample of Veterans and assessed their mental health service utilization. METHOD: This study used administrative data extracted from Veteran Health Administration outpatient records to identify patients with a new anxiety diagnosis in fiscal year 2010 (N = 292,244). Logistic regression analyses examined associations among diagnostic specificity, diagnostic location, and mental health service utilization. RESULTS:Anxiety NOS was diagnosed in 38% of the sample. Patients in specialty mental health were less likely to receive an anxiety NOS diagnosis than patients in primary care (odds ratio [OR] = 0.36). Patients with a specific anxiety diagnosis were more likely to receive mental health services than those with anxiety NOS (OR = 1.65), as were patients diagnosed in specialty mental health compared with those diagnosed in primary care (OR = 16.29). CONCLUSION: Veterans diagnosed with anxiety NOS are less likely to access mental health services than those with a specific anxiety diagnosis, suggesting the need for enhanced diagnostic and referral practices, particularly in primary care settings. Published by Elsevier Inc.
Entities:
Keywords:
Anxiety; Anxiety disorder not otherwise specified; Diagnostic; Mental health service utilization; Veteran
Authors: Terri L Barrera; Jeffrey A Cully; Amber B Amspoker; Nancy L Wilson; Cynthia Kraus-Schuman; Paula D Wagener; Jessica S Calleo; Ellen J Teng; Howard M Rhoades; Nicholas Masozera; Mark E Kunik; Melinda A Stanley Journal: J Anxiety Disord Date: 2015-05-07
Authors: Audrey L Jones; Susan D Cochran; Arleen Leibowitz; Kenneth B Wells; Gerald Kominski; Vickie M Mays Journal: J Gen Intern Med Date: 2015-06-03 Impact factor: 5.128