Access to psychotherapy for primary care patients with anxiety disorders.
Abstract
Anxiety disorders are common mental health problems in the community, and primary care has a predominant role in the diagnosis and treatment of these conditions. While most patients are treated with pharmacotherapy, clinical practice guidelines recommendations also comprise psychotherapy interventions. The aims of this study were: (a) to examine access to psychotherapy for anxiety disorders in a sample of primary care patients; and (b) to examine individual factors associated with access to psychotherapy. Data were drawn from the Dialogue project, a large primary care study conducted in 67 primary care clinics. After a mental health screening, patients with anxiety or depressive symptoms were invited to participate in a telephone/Web structured interview to assess Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) anxiety and depressive disorders, as well as service utilization. In our sample, a total of 740 adults met DSM-IV criteria for panic disorder, generalized anxiety disorder or social anxiety disorder in the past 12 months. Nearly half of the respondents with anxiety disorders had received a form of psychotherapy or counselling in the past 12 months, and 20% of respondents reported at least 12 sessions with the same health care professional. Individual correlates of access to psychotherapy, based on a logistic regression model, included being a woman, less than 60 years old, a university education level, supplementary insurance and having a comorbid depression episode. These findings emphasize the need to improve access to psychotherapy for individuals with anxiety disorders in primary care and to reduce disparities in access to psychotherapy.Keywords: anxiety disorder, primary care, evidence-based treatments, cognitive behavior therapy, service utilizationResumeLes troubles anxieux sont des problemes de sante mentale courants, et le secteur des soins primaires a un role important a jouer dans le diagnostic et le traitement de ces conditions. Si la plupart des patients sont traites au moyen de la pharmacotherapie, les lignes directrices de la pratique clinique recommandent aussi la psychotherapie. Les objectifs de cette etude etaient les suivants : a) examiner l'acces a la psychotherapie pour les troubles anxieux parmi un echantillon de patients de fournisseurs de soins primaires; b) examiner les facteurs individuels associes a l'acces a la psychotherapie. Des donnees ont ete tirees du projet Dialogue, une vaste etude sur les soins primaires realisee dans 67 cliniques. Apres un examen de depistage de troubles mentaux, les patients ayant des symptomes d'anxiete ou de depression ont ete invites a participer a une entrevue structuree par telephone ou basee sur le Web en vue d'evaluer les troubles anxieux et depressifs selon le Manuel diagnostique et statistique des troubles mentaux - 4e edition (DSM-IV), de meme que leur recours aux services. Dans notre echantillon, 740 adultes ont presente, au cours des 12 derniers mois, les criteres precises dans le DSM-IV pour le trouble panique, le trouble d'anxiete generalise ou la phobie sociale. Pres de la moitie des repondants ayant des troubles anxieux avaient recu une forme de psychotherapie ou du counseling au cours des 12 derniers mois, et 20 % des repondants ont dit avoir assiste a au moins 12 rencontres avec le meme professionnel de la sante. Les correlats individuels de l'acces a la psychotherapie, fondes sur un modele de regression logique, sont les suivants : etre une femme, etre âge de moins de 60 ans, avoir une education universitaire, posseder une assurance de soins complementaires et avoir eu un episode de depression comorbide. Ces resultats mettent en relief la necessite d'ameliorer l'acces des gens souffrant de troubles anxieux a la psychotherapie au sein du secteur des soins primaires et de reduire l'ecart dans l'acces a la psychotherapie.Mots-cles : trouble anxieux, soins primaires, traitement base sur des donnees probantes, therapie cognitivo-comportementale, utilisation des services. …
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Approximately 80% of people with generalized anxiety disorder do not receive an appropriate treatment due to geographical constraints.
“According to Roberge et al [30], approximately 80% of the people with GAD do not receive an appropriate treatment due to geographical constraints”
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“L’avenir Au Canada, pour les parents (Lee et al., 2014), les enfants (Eichstedt et al., 2014 ; Hunsley et al., 2014), les étudiants de niveau postsecondaire (Nunes et al., 2014) et les adultes (Roberge et al., 2014), les services psychologiques sont très peu accessibles.”
Background
- Authors
- Roberge, P., Fournier, L., Menear, M., & Duhoux, A.
- Venue
- Canadian Psychology / Psychologie canadienne
- Published
- 2014-05
- Volume
- 55
- Issue
- 2
- Pages
- 60-67
- ISSN
- 0708-5591 (ISSN-L)
- 1878-7304
- OpenAlex
- W2023788332
- Cited by
- 27
- References
- 0
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 7 · 2015: 1 · 2014: 2
- FWCI
- 5.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Canadian Psychology/Psychologie canadienne (publishedVersion)
- Funders
- Canadian Health Services Research Foundation
- Fonds de recherche du Québec—Santé
- Institut national de santé publique du Québec
- Quebec Ministry of Health and Social Services
- Groupe interdisciplinaire de recherche sur les urgences
- Canadian Institutes of Health Research
- MSSS
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- anxiety disorders, access to psychotherapy, primary care, service utilization, panic disorder, generalized anxiety disorder, social anxiety disorder, cognitive behavioral therapy, barriers to treatment, comorbid depression, gender differences, socioeconomic factors, supplementary insurance, mental health screening, treatment disparities, evidence-based treatment, Toronto
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