An international survey of reported prescribing practice in the treatment of patients with generalised anxiety disorder
Abstract
OBJECTIVE: To gain insight into the experience and practice of psychiatrists in the pharmacological management of patients with generalized anxiety disorder (GAD). METHODS: Multiple-choice questionnaire completed by 501 psychiatrists (representing a 45% response rate) from 18 countries, selected by pharmaceutical company representatives to attend a scientific meeting, through having an interest in anxiety disorders. RESULTS: Use of screening tools, routine structured diagnostic interviews, and practice guidelines was infrequent. Over one-third of patients did not receive their initial psychiatric consultation within a month after referral. A total of 45% of patients had symptoms for 2 years or longer before being diagnosed and treated. Most patients had been treated with benzodiazepines before referral. 80% of respondents always or often prescribed selective serotonin reuptake inhibitors (SSRIs), 43% serotonin-norepinephrine reuptake inhibitors (SNRIs), or pregabalin (35%) as first-line treatments. The most frequently recommended second-line treatments were SNRIs (41%) and pregabalin (36%). Concentration difficulties, fatigue, excessive worrying and pain were reported as the symptoms most difficult to manage. CONCLUSIONS: Patients with GAD have frequently been treated with benzodiazepines before referral to a psychiatrist. SSRIs were the preferred first-line treatment, and SNRIs and pregabalin preferred second-line treatments. Reported practice in this sample appears largely consistent with recent evidence-based treatment guidelines.
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Just under half of individuals with GAD suffer for 2 years before correct diagnosis, and waiting times for treatment are up to 18 weeks.
“Just under half of individuals with GAD suffer for 2 years before correctly being diagnosed [5], and even after diagnosis, waiting times for treatment are up to 18 weeks [6].”
In the past decade, a progressive change in prescribing pattern from benzodiazepines to second-generation antidepressants in anxiety disorders has been observed.
“In the past decade, a progressive change in the prescribing pattern from benzodiazepines to second generation antidepressants in anxiety disorders has been observed.74”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [74]
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- Authors
- Baldwin, D. S., Allgulander, C., Bandelow, B., Ferre, F., & Pallanti, S.
- Affiliations
- University of Southampton (GB)
- Karolinska Institutet (SE)
- University of Göttingen (DE)
- Hospital General Universitario Gregorio Marañón (ES)
- University of Florence (IT)
- Corresponding author
- Baldwin, David S.
- Venue
- The World Journal of Biological Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2011-11-07
- Volume
- 13
- Issue
- 7
- Pages
- 510-516
- ISSN
- 1562-2975 (ISSN-L)
- 1814-1412
- OpenAlex
- W2106235356
- Cited by
- 69
- References
- 23
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 5 · 2015: 3 · 2014: 8 · 2013: 9 · 2012: 4
- FWCI
- 8.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The World Journal of Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- GRO (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- generalized anxiety disorder, prescribing patterns, benzodiazepines, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, pregabalin, first-line therapy, second-line therapy, delayed diagnosis, psychiatric referral, guideline adherence
- MeSH terms
- Pregabalin, Antidepressive Agents, Anxiety Disorders, Benzodiazepines, Drug Therapy, Combination, Female, gamma-Aminobutyric Acid, Humans, Interview, Psychological, Male, Practice Patterns, Physicians', Surveys and Questionnaires, Referral and Consultation, Selective Serotonin Reuptake Inhibitors, Adrenergic Uptake Inhibitors, Health Care Surveys, Internationality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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