Journal of General Internal Medicine

, Volume 20, Issue 7, pp 623–628

Symptomatic severity of prime-MD diagnosed episodes of panic and generalized anxiety disorder in primary care

  • Bruce L. Rollman
  • Bea Herbeck Belnap
  • Sati Mazumdar
  • Fang Zhu
  • Kurt Kroenke
  • Herbert C. Schulberg
  • M. Katherine Shear
Original Article

DOI: 10.1007/s11606-005-0108-2

Cite this article as:
Rollman, B.L., Belnap, B.H., Mazumdar, S. et al. J GEN INTERN MED (2005) 20: 623. doi:10.1007/s11606-005-0108-2
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Abstract

BACKGROUND: Panic disorder (PD) and generalized anxiety disorder (GAD) are often unrecognized by primary care physicians (PCPs). The Primary Care Evaluation of Mental Disorders (PRIME-MD) has been used as a case-finding instrument for depression. Yet, little is known on its usefulness as a case-finding tool for anxiety disorders within the context of a clinical trial.

OBJECTIVE: To examine the: (1) completion rate of the PRIME-MD by patients approached to enroll in a treatment study for PD and GAD; (2) distribution of anxiety diagnoses generated; (3) severity of PD and GAD episodes thus identified; and (4) level of PCPs’ agreement with these diagnoses.

DESIGN: Cross-sectional interview.

PATIENTS: Individuals aged 18 to 64 who presented for care at 4 primary care practices.

MEASUREMENTS: The PRIME-MD, Structured Interview Guide for the Hamilton Anxiety Rating Scale (SIGH-A), and the Panic Disorder Severity Scale (PDSS).

RESULTS: Of the 6,700 patients who completed the PRIME-MD Patient Questionnaire (PQ), 2,926 (44%) screened positive for an anxiety disorder, and 1,216 (42%) met preliminary study eligibility and consented to the PRIME-MD Anxiety Module. Of these, 619 (51%) had either GAD (308), PD (94), or both (217) disorders. Later, 329 completed a telephone interview. Of these, 59% with GAD and 68% with PD reported moderate or greater levels of anxiety symptoms on the SIGH-A and PDSS, respectively, and PCPs agreed with the PRIME-MD diagnosis for 98% of these patients.

CONCLUSIONS: The PRIME-MD can efficiently screen patients for PD and GAD. Although patients thus identified endorse a wide range of anxiety symptoms, PCPs often agree with the diagnosis.

Key words

anxietypanicgeneralized anxiety disorderprimary careelectronic medical record system

Copyright information

© Society of General Internal Medicine 2005

Authors and Affiliations

  • Bruce L. Rollman
    • 1
  • Bea Herbeck Belnap
    • 1
  • Sati Mazumdar
    • 2
  • Fang Zhu
    • 2
  • Kurt Kroenke
    • 3
  • Herbert C. Schulberg
    • 4
  • M. Katherine Shear
    • 5
  1. 1.Division of General Internal Medicine, Center for Research on Health CareUniversity of Pittsburgh School of MedicinePittsburghUSA
  2. 2.Department of BiostatisticsUniversity of Pittsburgh Graduate School of Public HealthPittsburghUSA
  3. 3.Department of Medicine, Regenstrief InstituteIndiana UniversityIndianapolisUSA
  4. 4.Department of Psychiatry, Weill Medical CollegeCornell UniversityWhite PlainsUSA
  5. 5.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA