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首页> 外文期刊>BMC Family Practice >Recognizing and managing anxiety disorders in primary health care in Turkey
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Recognizing and managing anxiety disorders in primary health care in Turkey

机译：认识和管理土耳其初级卫生保健中的焦虑症

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Background Anxiety disorders are common and are frequently not diagnosed accurately in primary care. Our aim was to determine the knowledge gaps of general practitioners (GPs) in the diagnosis and treatment of anxiety disorders by using vignettes. Methods A cross-sectional survey was completed with 255 primary care physicians (response rate 59.4%) in Manisa, a city in western Turkey. From the postal questionnaire, information on working experience, postgraduate education in psychiatry, the interests of the physicians in psychiatry were obtained. The physicians' diagnosis and treatment preferences for generalized anxiety disorder (GAD), social phobia (SP), and obsessive compulsive disorder (OCD) were determined through clinical vignettes prepared for data collection. Results Two hundred and twenty-seven (89.0%) out of 255 GPs included the diagnosis of obsessive compulsive disorder in their differential diagnosis; however, the rates for social phobia and generalized anxiety disorder were 69.4% (n = 177) and 22.3% (n = 57), respectively. GPs with a post-graduate education on psychiatry diagnosed vignettes more accurately for OCD (p = 0.04). For all three cases, GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy. The referral rate to a psychiatrist was between 23.1 and 30.6%. The percentages of the prescription of selective serotonin reuptake inhibitors (SSRI) in accurate diagnosis were 59.3 for social phobia, 33.3 for GAD, and 55.5 for OCD. Conclusions There is a gap of knowledge in GPs, which leads to poor recognition and management of anxiety disorders in primary care. Effective interventions including post-graduate education and updated guidelines on anxiety disorders should be planned and implemented with their assessments by vignettes.
机译：背景焦虑症很常见，在初级保健中通常无法准确诊断。我们的目的是通过使用小插图来确定全科医生（GPs）在诊断和治疗焦虑症中的知识差距。方法在土耳其西部马尼萨市，由255名初级保健医生完成了横断面调查，答复率为59.4％。从邮政调查表中获得有关工作经验，精神病学研究生教育，精神病学医师兴趣的信息。通过为数据收集准备的临床小插曲确定了医生对广泛性焦虑症（GAD），社交恐惧症（SP）和强迫症（OCD）的诊断和治疗偏好。结果255名全科医生中有227名（89.0％）的诊断包括强迫症。然而，社交恐惧症和广泛性焦虑症的发生率分别为69.4％（n = 177）和22.3％（n = 57）。接受过精神病学研究生教育的全科医生可以更准确地诊断出强迫症（P = 0.04）。对于所有这三种情况，全科医生最喜欢采用包括心理疗法和心理药物疗法在内的联合疗法。推荐给精神科医生的比率在23.1至30.6％之间。准确诊断出选择性5-羟色胺再摄取抑制剂的处方百分率是，社交恐惧症为59.3％，GAD为33.3％，OCD为55.5％。结论全科医生的知识差距很大，这导致初级保健中对焦虑症的认识和管理较差。应计划和实施有效的干预措施，包括研究生教育和有关焦虑症的最新指南，并通过小插曲进行评估。

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