Treatment adequacy for social anxiety disorder in primary care patients.

OBJECTIVES:There is a gap between clinical practice guidelines for social anxiety disorder and clinical practice that needs to be addressed to ensure the delivery of evidence-based treatments. The objectives of this study were: 1) to describe mental health service utilization in a cohort of primary...

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Main Authors: Alexandra Chapdelaine, Jean-Daniel Carrier, Louise Fournier, Arnaud Duhoux, Pasquale Roberge
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6218038?pdf=render
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author Alexandra Chapdelaine
Jean-Daniel Carrier
Louise Fournier
Arnaud Duhoux
Pasquale Roberge
author_facet Alexandra Chapdelaine
Jean-Daniel Carrier
Louise Fournier
Arnaud Duhoux
Pasquale Roberge
author_sort Alexandra Chapdelaine
collection DOAJ
description OBJECTIVES:There is a gap between clinical practice guidelines for social anxiety disorder and clinical practice that needs to be addressed to ensure the delivery of evidence-based treatments. The objectives of this study were: 1) to describe mental health service utilization in a cohort of primary care patients with social anxiety disorder; 2) to examine treatment adequacy for pharmacotherapy and psychotherapy according to indicators based on clinical practice guidelines; and 3) to explore correlates of treatment adequacy. METHOD:The "Dialogue" project (Quebec, Canada) is a large study conducted in 67 primary care clinics. After a mental health screening in primary care (n = 14 833), participants with anxiety or depressive symptoms took part in a telephone/web structured interview on mental health symptoms and service utilization (n = 1956). This study included 289 participants meeting DSM-IV criteria for social anxiety disorder. RESULTS:Overall, 86.2% of participants reported consulting for mental health reasons over the past 12 months. Only 23.6% of our sample reported the detection of social anxiety disorder by a healthcare professional in the past 12 months. Approximately 2 in 5 respondents with social anxiety disorder reported receiving pharmacotherapy or psychotherapy meeting our treatment adequacy indicators. Antidepressant medication was the most common treatment. Logistic regression models showed that the detection of major depression (OR = 4.651; 95% CI: 2.559-8.453) or other anxiety disorder(s) (OR = 2.957; 95% CI: 1.555-5.625) were associated with receiving any adequate treatment, but the detection of social anxiety disorder itself was not (OR = 1.420; 95% CI: 0.696-2.899). CONCLUSION:Low rates of detection and treatment adequacy based on our indicators demonstrate that efforts must be made to ensure the quality of care for individuals with social anxiety disorder in primary care.
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spelling doaj.art-9ad8a519acae4d8cbfce3fa5273db4542022-12-22T02:40:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011311e020635710.1371/journal.pone.0206357Treatment adequacy for social anxiety disorder in primary care patients.Alexandra ChapdelaineJean-Daniel CarrierLouise FournierArnaud DuhouxPasquale RobergeOBJECTIVES:There is a gap between clinical practice guidelines for social anxiety disorder and clinical practice that needs to be addressed to ensure the delivery of evidence-based treatments. The objectives of this study were: 1) to describe mental health service utilization in a cohort of primary care patients with social anxiety disorder; 2) to examine treatment adequacy for pharmacotherapy and psychotherapy according to indicators based on clinical practice guidelines; and 3) to explore correlates of treatment adequacy. METHOD:The "Dialogue" project (Quebec, Canada) is a large study conducted in 67 primary care clinics. After a mental health screening in primary care (n = 14 833), participants with anxiety or depressive symptoms took part in a telephone/web structured interview on mental health symptoms and service utilization (n = 1956). This study included 289 participants meeting DSM-IV criteria for social anxiety disorder. RESULTS:Overall, 86.2% of participants reported consulting for mental health reasons over the past 12 months. Only 23.6% of our sample reported the detection of social anxiety disorder by a healthcare professional in the past 12 months. Approximately 2 in 5 respondents with social anxiety disorder reported receiving pharmacotherapy or psychotherapy meeting our treatment adequacy indicators. Antidepressant medication was the most common treatment. Logistic regression models showed that the detection of major depression (OR = 4.651; 95% CI: 2.559-8.453) or other anxiety disorder(s) (OR = 2.957; 95% CI: 1.555-5.625) were associated with receiving any adequate treatment, but the detection of social anxiety disorder itself was not (OR = 1.420; 95% CI: 0.696-2.899). CONCLUSION:Low rates of detection and treatment adequacy based on our indicators demonstrate that efforts must be made to ensure the quality of care for individuals with social anxiety disorder in primary care.http://europepmc.org/articles/PMC6218038?pdf=render
spellingShingle Alexandra Chapdelaine
Jean-Daniel Carrier
Louise Fournier
Arnaud Duhoux
Pasquale Roberge
Treatment adequacy for social anxiety disorder in primary care patients.
PLoS ONE
title Treatment adequacy for social anxiety disorder in primary care patients.
title_full Treatment adequacy for social anxiety disorder in primary care patients.
title_fullStr Treatment adequacy for social anxiety disorder in primary care patients.
title_full_unstemmed Treatment adequacy for social anxiety disorder in primary care patients.
title_short Treatment adequacy for social anxiety disorder in primary care patients.
title_sort treatment adequacy for social anxiety disorder in primary care patients
url http://europepmc.org/articles/PMC6218038?pdf=render
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