GPs may be reluctant to formally record anxiety disorder, even though a diagnosis of anxiety may encourage patients to engage with treatment, a study has suggested.
The authors of the study published in the British Journal of General Practice (BJGP) on 6 April, interviewed 15 GPs and 20 patients, to better understand the value of diagnosing anxiety disorders in primary care.
The study said: ‘Patients’ accounts indicated that they valued having a diagnosis, as this helped them to view anxiety as a medical condition, and to think about how they were going to get better and engage with treatment.’
Continuity of care over several consultations is also important in improving patients’ understanding and engagement with managing anxiety symptoms, the study suggested.
‘This is pertinent when considering the increasing use of telephone appointments as a result of the Covid-19 pandemic, as patients with anxiety may find it particularly difficult to disclose symptoms over the phone,’ it said.
Improving patient options
The authors said that although GPs may consider diagnosis as ‘being potentially stigmatising’, patients felt that receiving a diagnosis helped them understand their symptoms and the need for treatment.
Some GPs reported that providing a diagnosis of anxiety could be unhelpful if it encouraged patients to adopt a ‘sick role’. Additionally, some felt reluctant to diagnose anxiety disorder as ‘because they had limited time with patients and felt this was the role of a psychiatrist’.
Some GPs said that recording a diagnosis of anxiety would have ‘minimal impact’, as using terms like anxiety or depression do not influence the treatment pathway.
The study said: ‘They explained this was because the waiting time to access talking therapies was lengthy, secondary mental health care for anxiety was difficult to access and the threshold for accessing psychiatric support too high for this patient group.’
The study noted that evidence indicates one in six adults in England meet the criteria for anxiety or depression which presents ‘an increasing challenge for GPs, as most anxiety is managed in primary care’.
The authors also reported a reluctance on behalf of patients to discuss their symptoms, which it said may account for a decrease in diagnoses.
Patients were worried about ‘how to build rapport with the GP’ while talking about anxiety, the study said, adding that this was worsened by ‘a lack of continuity of care, with patients finding it hard to disclose symptoms of anxiety to GPs they had no prior relationship with’.
Others said that they felt their anxiety was not serious enough to take up their GPs’ time, with some reporting a lack of awareness that they were experiencing anxiety, assuming their physical symptoms (like chest pains) were related to physical problems.