Better Diagnosis of Anxiety Could Improve Care for Veterans
By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on December 9, 2013
A new study discovers that many veterans receive a diagnosis of
generalized anxiety rather than a more accurate, specific diagnosis of
Accordingly, veterans who suffer from anxiety may not get appropriate
treatment for their particular condition.
Lead researcher Terri L. Barrera, Ph.D., and her colleagues at the
Michael E. DeBakey VA Medical Center in Houston looked at data from
Veterans Health Administration outpatient records for patients with
As reported in the journal General Hospital Psychiatry, the researchers
discovered 38 percent of the sample was diagnosed with anxiety
The research team expected to find that a diagnosis of anxiety NOS
disorder was only used temporarily until a more specific diagnosis was
decided on. That was not the case.
“Unfortunately, our results suggested that only 12 percent of the
patients with an initial anxiety NOS diagnosis received a specific
anxiety diagnosis within the year,” said Barrera.
Anxiety might be related to post-traumatic stress or be a symptom of
generalized anxiety disorder, panic disorder, obsessive-compulsive
disorder, social anxiety disorder or a specific phobia.
While treatments for various anxiety disorders are similar, usually
including medication and behavioral therapy, the approach might differ.
Veterans with a specific anxiety diagnosis were more likely to receive
mental health services.
From 60 to 67 percent of those with the most frequently diagnosed
specific anxiety disorders received treatment, while only 32 percent of
patients with a non-specific diagnosis received mental health services
during the year following diagnosis.
“While anxiety is a problem for all who suffer from it, getting the
correct treatment is especially important for veterans. Within any given
year, 18 percent of the general population may be diagnosed with
anxiety. For veterans, it’s 33 percent.
“Veterans are twice as likely to experience clinical levels of anxiety
than the general public,” said Barrera.
“Anxiety disorders can be devastating, and are associated with increased
disability and risk for suicide.”
Unfortunately, anxiety disorders may go unrecognized and untreated,
particularly in primary care settings.
Primary care providers only detect 50 percent of patients with mental
health problems, note the researchers. Even fewer are adequately treated
or referred for specific mental health services.
“It’s important to do regular screening in any high-risk population,”
said Shirley Glynn, Ph.D., a research psychologist and co-director of
UCLA’s Welcome Back Veterans Family Resilience Center.
“We want to be more diligent and do screening early so we can offer
intervention if needed, so the condition won’t become more chronic.”
Anxiety NOS is frequently used as a temporary diagnosis with the
expectation that the health care provider will eventually make a more
specific diagnosis at a later date.
One problem with not making a specific diagnosis is that primary care
doctors may not know who to refer patients to, notes Glynn.
“Right now there are several models to improve treatment,” said Glynn.
“One involves having a mental health professional located in a primary
care clinic, such as a psychiatric nurse, a psychologist or a
psychiatrist who is available in a timely manner to provide a
“Another possibility is to utilize short screening questionnaires with
patients before they see a physician and then these can be reviewed with
Source: CFAH – Health Behavioral News Service