1. Anxiety disorders: Psychiatric comorbidities and psychosocial stressors among adult outpatients
- Author
-
Maggy Liebenberg, Gina Joubert, Carla Nel, Linda Augustyn, Jurgens Naudé, Nandie Bartman, and Marizél Koen
- Subjects
medicine.medical_specialty ,lcsh:RC435-571 ,generalised anxiety disorder ,behavioral disciplines and activities ,lcsh:RZ400-408 ,03 medical and health sciences ,0302 clinical medicine ,anxiety disorders ,lcsh:Psychiatry ,mental disorders ,agoraphobia ,psychosocial stressors ,medicine ,panic disorder ,Psychiatry ,business.industry ,Panic disorder ,Social anxiety ,Panic ,lcsh:Mental healing ,medicine.disease ,Comorbidity ,Personality disorders ,030227 psychiatry ,Psychiatry and Mental health ,psychiatric comorbidity ,Anxiety ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Anxiety disorder ,Agoraphobia - Abstract
Background: Anxiety disorders are the most prevalent class of lifetime mental disorders according to South African research. However, little is known about the prevalence of factors that might complicate treatment among adults in a psychiatric outpatient setting. Aim: To explore the psychiatric comorbidities and psychosocial stressors among a population of adults treated for anxiety disorders at the outpatient unit of a tertiary psychiatric facility in Bloemfontein. Methods: In this retrospective cross-sectional study, clinical files of all mental healthcare users receiving treatment were reviewed to identify those with a current or previous diagnosis of one or more of the following anxiety disorders: generalised anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD) and agoraphobia. Results: Of the 650 available records, 103 (15.8%) included at least one anxiety disorder. Of those, 65.1% had GAD, 34.0% had panic disorder and 29.1% had SAD. Agoraphobia was diagnosed in 14.6% of patients almost exclusively as comorbid with panic disorder. Additional psychiatric disorders were present for 98.1% of patients and 36.9% had multiple anxiety disorders. The patients had a history of relational problems (64.1%), educational and occupational stressors (55.3%), abuse and neglect (28.2%), other problems related to the social environment (24.3%) and self-harm (23.3%). Conclusion: Clinical practice should take the high rates of comorbidity into account and the importance of integrated substance-related interventions in mental healthcare settings is clear. Diagnostic practices regarding agoraphobia without panic, and the comorbidity of anxiety and personality disorders should receive further attention. Clinicians should be aware of the potential impact of the frequently reported psychosocial stressors.
- Published
- 2018
- Full Text
- View/download PDF